Individual provider Active NPI

Belkis Perez, APRN

  • Family Nurse Practitioner
  • Lakeland, FL
National Provider Identifier
1649940768
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11015470 Issued in FL
Practice address
4715 S Florida Ave Ste 200
Lakeland, FL 33813-2101
Phone
(863) 209-7004
Fax
(863) 274-3542
NPI assigned
Sep 20, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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 11015470 FL Primary

Addresses

Primary practice location

4715 S Florida Ave Ste 200
Lakeland, FL 33813-2101

Mailing address

4715 S Florida Ave Ste 200
Lakeland, FL 33813-2101
Phone (863) 209-7004

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
I20211124001913 FL Practitioner - Nurse Practitioner 1557751021 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11015470FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Mar 1, 2025 Accepting new patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Mar 1, 2025 Accepting new patients

Locations

4715 S Florida Ave
Ste 200
Lakeland, FL 33813
Phone (863) 209-7004

4715 S Florida Ave
Lakeland, FL 33813
Phone (863) 209-7003

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 2

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": "1632096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1649940768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4715 S FLORIDA AVE STE 200",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132101",
            "telephone_number": "863-209-7004",
            "fax_number": "863-274-3542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4715 S FLORIDA AVE STE 200",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132101",
            "telephone_number": "863-209-7004",
            "fax_number": "863-274-3542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "BELKIS",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-20",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11015470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.