Individual provider Active NPI

Estefania Perez, NP

  • Family Nurse Practitioner
  • Port Charlotte, FL
National Provider Identifier
1649741612
Registry record updated Oct 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9421816 Issued in FL
Practice address
3280 Tamiami TRL # 55a-294
Port Charlotte, FL 33952-8053
Phone
(323) 684-7024
NPI assigned
Dec 17, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 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 9421816 FL Primary

Addresses

Primary practice location

3280 Tamiami TRL # 55a-294
Port Charlotte, FL 33952-8053

Mailing address

3280 Tamiami TRL # 55a-294
Port Charlotte, FL 33952-8053
Phone (323) 684-7024

Other practice location 1

3280 Tamiami Trail 55A-294
Port Charlotte, FL 33952
Phone (323) 684-7024

Other practice location 2

17093 Best Ave
Port Charlotte, FL 33954-2713
Phone (323) 684-7024

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9421816FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Intellimed Health Current Accepting new patients
Trucare Med, Inc PastSince Feb 1, 2019 Accepting new patients
Clean Medics, LLC PastSince Feb 1, 2021 Accepting new patients

Organizations & group practices 3

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": "1545004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1649741612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3280 TAMIAMI TRL # 55A-294",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339528053",
            "telephone_number": "323-684-7024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3280 TAMIAMI TRL # 55A-294",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339528053",
            "telephone_number": "323-684-7024"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3280 Tamiami Trail 55A-294",
            "address_purpose": "LOCATION",
            "city": "Port Charlotte",
            "state": "FL",
            "postal_code": "33952",
            "country_code": "US",
            "telephone_number": "323-684-7024",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17093 Best Ave",
            "address_purpose": "LOCATION",
            "city": "Port Charlotte",
            "state": "FL",
            "postal_code": "339542713",
            "country_code": "US",
            "telephone_number": "323-684-7024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "ESTEFANIA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-17",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9421816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.