Provider Demographics
NPI:1710702188
Name:HERNANDEZ PEREZ, ALEXEY
Entity type:Individual
Prefix:
First Name:ALEXEY
Middle Name:
Last Name:HERNANDEZ PEREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16531 BLATT BLVD APT 105
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-1828
Mailing Address - Country:US
Mailing Address - Phone:239-922-3935
Mailing Address - Fax:
Practice Address - Street 1:55 WESTON RD STE 101B
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-1112
Practice Address - Country:US
Practice Address - Phone:954-659-1208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-20
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9671708163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse