Individual provider Active NPI

Elvis Alfonso Perez

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1982112967
Registry record updated Jan 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9375057 Issued in FL
Practice address
12423 SW 27TH St
Miami, FL 33175-2106
Phone
(786) 212-0742
NPI assigned
Jan 12, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2018

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 9375057 FL Primary

Addresses

Primary practice location

12423 SW 27TH St
Miami, FL 33175-2106

Mailing address

12423 SW 27TH St
Miami, FL 33175-2106
Phone (786) 212-0742

Other identifiers 1

IdentifierTypeStateIssuer
9375057MedicaidFL

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
I20250624003879 FL Practitioner - Nurse Practitioner 5193249662 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9375057FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Callisia Health Group Inc CurrentSince Apr 20, 2025 Accepting new patients
Medella Medical Center CurrentSince Jun 15, 2025 Accepting new patients

Locations

11440 SW 88th St
Ste 208
Miami, FL 33176
Phone (305) 279-5535

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": "1515715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515715200000",
    "number": "1982112967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12423 SW 27TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331752106",
            "telephone_number": "786-212-0742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12423 SW 27TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331752106",
            "telephone_number": "786-212-0742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALFONSO PEREZ",
        "first_name": "ELVIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-12",
        "last_updated": "2018-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9375057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9375057",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.