Provider Demographics
NPI:1053034512
Name:PEREZ MACHADO, NOSLEN (APRN)
Entity type:Individual
Prefix:MR
First Name:NOSLEN
Middle Name:
Last Name:PEREZ MACHADO
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4202 NW 76TH AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-2034
Mailing Address - Country:US
Mailing Address - Phone:305-905-9851
Mailing Address - Fax:
Practice Address - Street 1:4202 NW 76TH AVE
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-2034
Practice Address - Country:US
Practice Address - Phone:305-905-9851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11021814363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily