Provider Demographics
NPI:1679108773
Name:PEREZ MORENO, MADELEY
Entity type:Individual
Prefix:
First Name:MADELEY
Middle Name:
Last Name:PEREZ MORENO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 W 68TH ST APT 201
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-5392
Mailing Address - Country:US
Mailing Address - Phone:786-915-9917
Mailing Address - Fax:
Practice Address - Street 1:240 W 68TH ST APT 201
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-5392
Practice Address - Country:US
Practice Address - Phone:786-915-9917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-09
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide