Basic Information
| Provider Information | |||||||||
| NPI: | 1386661973 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PEREZ | ||||||||
| FirstName: | EMILIANA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | MSN ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8828 BLISS ROAD | ||||||||
| Address2: | |||||||||
| City: | GIBSONTON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33534 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8136772757 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10508 GIBSONTON DR | ||||||||
| Address2: | |||||||||
| City: | RIVERVIEW | ||||||||
| State: | FL | ||||||||
| PostalCode: | 335785434 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9549839191 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2006 | ||||||||
| LastUpdateDate: | 04/13/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/13/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | ARNP3127132 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.