Provider Demographics
NPI:1043990591
Name:TEJADA PEREZ, KIRA A (MSN,APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:KIRA
Middle Name:A
Last Name:TEJADA PEREZ
Suffix:
Gender:F
Credentials:MSN,APRN, FNP-BC
Other - Prefix:
Other - First Name:KIRA
Other - Middle Name:
Other - Last Name:TEJADA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:12955 BISCAYNE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-2021
Mailing Address - Country:US
Mailing Address - Phone:786-245-3035
Mailing Address - Fax:
Practice Address - Street 1:12955 BISCAYNE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2021
Practice Address - Country:US
Practice Address - Phone:786-245-3035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-19
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11027616363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily