Provider Demographics
NPI:1144909094
Name:LANDIN PEREZ, JOSUE (ARNP)
Entity type:Individual
Prefix:MR
First Name:JOSUE
Middle Name:
Last Name:LANDIN PEREZ
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18862 NW 86TH CT APT 4002
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-7232
Mailing Address - Country:US
Mailing Address - Phone:786-362-4390
Mailing Address - Fax:
Practice Address - Street 1:15529 BULL RUN RD
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-7004
Practice Address - Country:US
Practice Address - Phone:305-328-8922
Practice Address - Fax:786-224-6489
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11025021363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily