Individual provider Active NPI

Nelly Marie Perez, M.D.

  • Internal Medicine Physician
  • Bonita Springs, FL
National Provider Identifier
1407948680
Registry record updated Mar 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME71420 Issued in FL
Practice address
3501 Health Center Blvd
#2160
Bonita Springs, FL 34135-8127
Phone
(239) 948-4470
Fax
(239) 948-0933
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME71420 FL Primary

Addresses

Primary practice location

3501 Health Center Blvd
#2160
Bonita Springs, FL 34135-8127

Mailing address

3501 Health Center Blvd
#2160
Bonita Springs, FL 34135-8127
Phone (239) 948-4470

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100611000325 FL Practitioner - Internal Medicine 8820128259 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guzman-Huesca and Perez LLCGroup PAC ID 8527367820, 2 clinicians

Practice addresses (Care Compare)

27399 Riverview Ctr Blvd
Bonita Springs, FL 34134-4311
Phone (239) 948-4470

Hospital & facility affiliations

  • Trilogy Home Healthcare Home health agency, Estero, FL, CCN 108173
  • Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012
  • Naples Community Hospital Hospital, Naples, FL, CCN 100018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME71420FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Guzman-Huesca & Perez LLC Internal Medicine CurrentSince Jan 1, 2016 Accepting new patients

Locations

27399 Riverview Center Blvd
Ste 100
Bonita Springs, FL 34134

27399 Riverview Center Blvd
Ste 101
Bonita Springs, FL 34134
Phone (239) 498-4910

3501 Health Center Blvd
Ste 2160
Estero, FL 34135
Phone (239) 495-9751

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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 3

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427328000000",
    "number": "1407948680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 HEALTH CENTER BLVD",
            "address_2": "#2160",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341358127",
            "telephone_number": "239-948-4470",
            "fax_number": "239-948-0933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 HEALTH CENTER BLVD",
            "address_2": "#2160",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341358127",
            "telephone_number": "239-948-4470",
            "fax_number": "239-948-0933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "NELLY",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2015-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME71420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonita Springs, FL

Sources for this page

Verify at the official NPI Registry.