Basic Information
| Provider Information | |||||||||
| NPI: | 1508488347 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PEREZ | ||||||||
| FirstName: | CHABELY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5828 EAGLE CAY TER | ||||||||
| Address2: | |||||||||
| City: | COCONUT CREEK | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330732611 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7863069893 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 451 5 WILES ROAD | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | COCONUT CREEK | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330733414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9549431133 | ||||||||
| FaxNumber: | 9547836845 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/14/2020 | ||||||||
| LastUpdateDate: | 10/21/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | APRN11007069 | FL | Y | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.