Individual provider Active NPI

Alien R Perez Sr., APRN

  • Family Nurse Practitioner
  • Lighthouse Point, FL
National Provider Identifier
1558825463
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11000227 Issued in FL
Practice address
3138 N Federal Hwy
Lighthouse Point, FL 33064-6738
Phone
(305) 266-2929
NPI assigned
Jan 24, 2019
Last updated
Apr 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 815928 NV
Family Nurse Practitioner 363LF0000X 11000227 FL Primary

Addresses

Primary practice location

3138 N Federal Hwy
Lighthouse Point, FL 33064-6738

Mailing address

11561 NW 87TH PL
Hialeah Gardens, FL 33018-1959
Phone (786) 538-2750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190717003650 NV Practitioner - Nurse Practitioner 1850626557 Reassigns benefits to 1 organization
I20210921003353 FL Practitioner - Nurse Practitioner 1850626557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centrum Medical Holdings, LLCGroup PAC ID 8820422991, 51 clinicians

Practice addresses (Care Compare)

3138 N Federal Hwy
Lighthouse Point, FL 33064-6738
Phone (305) 266-2929

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11000227FLMDFamily Nurse Practitioner
815928NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Med Care Centers LLC Current Accepting new patients
Medcare Centers, LLC CurrentSince Apr 24, 2024 Accepting new patients
Centrum Medical Holdings, LLC CurrentSince Jun 15, 2021 Accepting new patients
Medcare Centers, LLC CurrentSince Apr 24, 2024 Accepting new patients
Centrum Medical Centers Kendall, LLC CurrentSince Jun 15, 2021 Accepting new patients

Locations

1801 N University Dr
Ste 101
Coral Springs, FL 33071
Phone (954) 344-8100

8844A W State Road 84
Ste G10
Davie, FL 33324

9250 NW 36th St
Ste 420
Doral, FL 33178

3690 Davie Blvd
Ft Lauderdale, FL 33312
Phone (954) 833-0010

1460 E Hallandale Beach Blvd
Hallandale Beach, FL 33009
Phone (954) 455-2385

2229 Sheridan St
Hollywood, FL 33020
Phone (954) 251-2381

3138 N Federal Hwy
Lighthouse Point, FL 33064

612 S State Road 7
Margate, FL 33068
Phone (954) 535-1919

7200 NW 7th St
Ste 150
Miami, FL 33126
Phone (305) 264-6270

12709 Miramar Pkwy
Miramar, FL 33027
Phone (786) 970-8010

5730 SW 74th St
Ste 200
South Miami, FL 33143

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1548288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1558825463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11561 NW 87TH PL",
            "city": "HIALEAH GARDENS",
            "state": "FL",
            "postal_code": "330181959",
            "telephone_number": "786-538-2750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3138 N FEDERAL HWY",
            "city": "LIGHTHOUSE POINT",
            "state": "FL",
            "postal_code": "330646738",
            "telephone_number": "305-266-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "ALIEN",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-24",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "815928",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11000227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lighthouse Point, FL

Sources for this page

Verify at the official NPI Registry.