Basic Information
| Provider Information | |||||||||
| NPI: | 1477952414 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PEREZ-GARCIA | ||||||||
| FirstName: | AGALY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 NW 57TH CT STE 200 | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331263284 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3056498100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 291 SW 27TH AVE | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331351401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3058581828 | ||||||||
| FaxNumber: | 3058566786 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2014 | ||||||||
| LastUpdateDate: | 01/16/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | F0814145 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.