Provider Demographics
NPI:1326849084
Name:PEREZ, JESSLYN (APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:JESSLYN
Middle Name:
Last Name:PEREZ
Suffix:
Gender:
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16618 NW 70TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-7102
Mailing Address - Country:US
Mailing Address - Phone:305-495-3035
Mailing Address - Fax:
Practice Address - Street 1:600 SILKS RUN UNIT 1265
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-2570
Practice Address - Country:US
Practice Address - Phone:786-567-3507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11037826363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner