| Doctor Name: | MR. JOSE PEREZ |
| NPI Number: | 1053739169 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RN |
| License Number: | 299993849 |
| Business Practice Address: | 11814 N 56th St Ste A Temple Terrace, FL - 336171698 |
| Business Phone Number: | 8136429000 |
| Business Fax Number: | 8136429001 |
| Mailing Address: | 11814 N 56th St Ste A, TEMPLE TERRACE |
| State: | FL |
| Postal Code: | 336171698 |
| Phone Number: | 8136429000 |
| Fax Number: | 8136429001 |
| NPI Enumeration Date: | 04/04/2014 |
| NPI Last Update Date: | 05/05/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WH0200X |
| License Number: | 299993849 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Home Health |
| Taxonomy Definition: | |