Provider Demographics
NPI:1366334021
Name:PEREZ, JULISSA MARIE (MSN, CPNP-PC)
Entity type:Individual
Prefix:
First Name:JULISSA
Middle Name:MARIE
Last Name:PEREZ
Suffix:
Gender:F
Credentials:MSN, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16600 NW 77TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-3432
Mailing Address - Country:US
Mailing Address - Phone:305-785-1555
Mailing Address - Fax:
Practice Address - Street 1:16600 NW 77TH PL
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-3432
Practice Address - Country:US
Practice Address - Phone:305-785-1555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9479985163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse