1912157322 NPI number — MRS. JULIE L SWEET-PEREZ ARNP

Table of content: MRS. JULIE L SWEET-PEREZ ARNP (NPI 1912157322)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912157322 NPI number — MRS. JULIE L SWEET-PEREZ ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SWEET-PEREZ
Provider First Name:
JULIE
Provider Middle Name:
L
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912157322
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/13/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8 CADILLAC DR
Provider Second Line Business Mailing Address:
SUITE 250
Provider Business Mailing Address City Name:
BRENTWOOD
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37027-5087
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-425-4200
Provider Business Mailing Address Fax Number:
615-425-4271

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2873 S ORANGE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ORLANDO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32806-5403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-316-0176
Provider Business Practice Location Address Fax Number:
407-316-0129
Provider Enumeration Date:
09/22/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  ARNP9192327 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 114203800 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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