Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 11010813 | FL |
NPI | 1003404369 |
---|---|
Provider Name | Yamell Martin Perez |
First Address | Cape Coral, FL 33990-4663 |
Second Address | Cape Coral, FL 33990-4663 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2021 |
Last Update Date | 04/01/2021 |