Susel Ivet Perez Nieves

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN23009 Issued in FL

Practice address

618 Atlantic Shores Blvd Ste 101
Hallandale Beach, FL 33009-2596

Phone

(954) 456-7900

Fax

(954) 362-2404

NPI assigned

Mar 16, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Networks

• Freedom Health HMO Network

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

{
    "created_epoch": "1426464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1972996981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 ATLANTIC SHORES BLVD STE 101",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330092596",
            "telephone_number": "954-456-7900",
            "fax_number": "954-362-2404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 ATLANTIC SHORES BLVD STE 101",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330092596",
            "telephone_number": "954-456-7900",
            "fax_number": "954-362-2404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ NIEVES",
        "first_name": "SUSEL",
        "middle_name": "IVET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-16",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN23009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric Hospitalist of South Florida PA
• Sharon Pedrosa, PSYD
• Luana Pedrozo, PT
• Maria Gabriela Peinado
• Edith Pena
• Gerardo Perez-Garcia, MSN., RN., FNP-BC
• Alba Lucia Perez, AP,MM, NC, CC
• Jesslyn Perez, APRN, FNP-BC
• Personal Physician Management Group of Hallandale, Inc.
• Peter Tomasello D O P a

• General Practice Dentistry in Hallandale Beach, FL
• Providers in Hallandale Beach, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; 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.