Provider Demographics
NPI:1053184341
Name:ORTEGA PEREZ, JUMIRLET (APRN)
Entity type:Individual
Prefix:
First Name:JUMIRLET
Middle Name:
Last Name:ORTEGA PEREZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JUMIRLET
Other - Middle Name:
Other - Last Name:ORTEGA PEREZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:1211 W 33RD ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-4807
Mailing Address - Country:US
Mailing Address - Phone:786-202-9563
Mailing Address - Fax:
Practice Address - Street 1:6161 BLUE LAGOON DR STE 170
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-2045
Practice Address - Country:US
Practice Address - Phone:786-388-1400
Practice Address - Fax:786-388-1219
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11029443363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily