Provider Demographics
NPI:1972335040
Name:MONTES DE OCA PEREZ, JUAN CARLOS (APRN FNP)
Entity type:Individual
Prefix:
First Name:JUAN CARLOS
Middle Name:
Last Name:MONTES DE OCA PEREZ
Suffix:
Gender:M
Credentials:APRN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13490 SW 271ST LN
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-8567
Mailing Address - Country:US
Mailing Address - Phone:786-286-3678
Mailing Address - Fax:
Practice Address - Street 1:13490 SW 271ST LN
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-8567
Practice Address - Country:US
Practice Address - Phone:786-286-3678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-16
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11034868363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily