Individual provider Active NPI

Vanessa Marie Perez, PA-C

  • Physician Assistant
  • Palm Beach Gardens, FL
National Provider Identifier
1063304079
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9120669 Issued in FL
Practice address
11211 Prosperity Farms Rd Ste C211
Palm Beach Gardens, FL 33410-3401
Phone
(561) 743-4911
NPI assigned
Jul 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9120669 FL Primary

Addresses

Primary practice location

11211 Prosperity Farms Rd Ste C211
Palm Beach Gardens, FL 33410-3401

Mailing address

11211 Prosperity Farms Rd Ste C211
Palm Beach Gardens, FL 33410-3401
Phone (561) 743-4911

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
I20251022000193 FL Practitioner - Physician Assistant 2860980836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Nova Southeastern College of Osteo Medicine, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5942 Las Colinas Cir
Lake Worth, FL 33463-6559

Hospital & facility affiliations

  • Jupiter Medical Center Hospital, Jupiter, FL, CCN 100253

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9120669FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lori Lynn Dowie DO PA CurrentSince Oct 10, 2025 Accepting new patients

Locations

11211 Prosperity Farms Rd
Ste C211
Palm Beach Gardens, FL 33410
Phone (561) 743-4911

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1752624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1063304079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11211 PROSPERITY FARMS RD STE C211",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334103401",
            "telephone_number": "561-743-4911",
            "fax_number": "561-743-2998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11211 PROSPERITY FARMS RD STE C211",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334103401",
            "telephone_number": "561-743-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "VANESSA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-16",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9120669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

Verify at the official NPI Registry.