Provider Demographics
NPI:1245778794
Name:PEREZ, MARIA VICTORIA HONGCO
Entity type:Individual
Prefix:
First Name:MARIA VICTORIA
Middle Name:HONGCO
Last Name:PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 WHITE MAGNOLIA LOOP
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-6253
Mailing Address - Country:US
Mailing Address - Phone:352-250-7556
Mailing Address - Fax:
Practice Address - Street 1:10701 INTERNATIONAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32821-7392
Practice Address - Country:US
Practice Address - Phone:407-355-0929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-04
Last Update Date:2017-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9191229363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily