Individual provider Active NPI

Mariela Perez

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1063062842
Registry record updated Sep 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11000797 Issued in FL
Practice address
11101 SW 47TH St
Miami, FL 33165-6105
Phone
(786) 312-0586
NPI assigned
Sep 13, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11000797 FL Primary

Addresses

Primary practice location

11101 SW 47TH St
Miami, FL 33165-6105

Mailing address

11101 SW 47TH St
Miami, FL 33165-6105
Phone (786) 312-0586

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230130001870 FL Practitioner - Nurse Practitioner 0446621494 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11000797FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Florida Internists Group PA CurrentSince Oct 14, 2022 Accepting new patients

Locations

1312 SW 27th Ave
Fl 3
Miami, FL 33145
Phone (786) 409-2407

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1568332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568332800000",
    "number": "1063062842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11101 SW 47TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331656105",
            "telephone_number": "786-312-0586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11101 SW 47TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331656105",
            "telephone_number": "786-312-0586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "MARIELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-13",
        "last_updated": "2019-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11000797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.