Lister Perez, Annet Tamara
Lister Perez, Annet Tamara is an sole proprietor health care provider with primary practice located at 3501 Del Prado Blvd S Ste 303 , Cape Coral FL 33904-7222. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Lister Perez, Annet Tamara can be contacted via phone (239) 317-0265.Contact Information
Primary practice address
3501 Del Prado Blvd S Ste 303
Cape Coral FL 33904-7222
Phone: (239) 317-0265
Fax: (239) 673-7681
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 11007889 | Florida |
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | APRN110078 | Florida |
Profile Details
NPI number | 1164040259 |
---|---|
LBN Legal business name | Lister Perez, Annet Tamara |
Credentials | Advanced Practice Registered Nurse (APRN) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jul 6th, 2020 |
Last updated | Jan 29th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1164040259 | NPPES |
Florida | MEDICAID | 109138300 |
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