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Individual

MR. JOSE PEREZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
11814 N 56TH ST STE A, TEMPLE TERRACE, FL 33617-1698
(813) 642-9000
(813) 642-9001
Mailing address
11814 N 56TH ST STE A, TEMPLE TERRACE, FL 33617-1698
(813) 642-9000
(813) 642-9001

Taxonomy

Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
299993849
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10-9785
PTAN
FL
Enumeration date
04/04/2014
Last updated
05/05/2014
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