Individual
MRS. ANNET TAMARA LISTER PEREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3501 DEL PRADO BLVD S STE 303, CAPE CORAL, FL 33904-7222
(239) 317-0265
(239) 673-7681
Mailing address
1123 SE 19TH LN, CAPE CORAL, FL 33990-4532
(305) 572-3747
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
11007889
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN110078
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109138300
—
FL
Enumeration date
07/06/2020
Last updated
01/29/2021
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