Provider Demographics
NPI:1588405104
Name:PEREZ MENA, DAIMYS MARIA (APRN)
Entity type:Individual
Prefix:MRS
First Name:DAIMYS
Middle Name:MARIA
Last Name:PEREZ MENA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 558202
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33255-8202
Mailing Address - Country:US
Mailing Address - Phone:305-467-9750
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 558202
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33255-8202
Practice Address - Country:US
Practice Address - Phone:305-467-9750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9351189207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty