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NPI Code Detail

MEDICARE: DAILEN PEREZ MEDERO

MEDICARE: DAILEN PEREZ MEDERO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1124894373
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAILEN PEREZ MEDERO
Provider Business Mailing Address
First Line : 2005 S CONGRESS AVE UNIT 206
Second Line :
City : PALM SPRINGS
State : FL
Zip : 33406-7632
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6145 LAKE WORTH RD STE A
Second Line :
City : GREENACRES
State : FL
Zip : 33463-3001
Country : US
Telephone Number : 561-421-0047
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2023
Last Update Date : 03/03/2026

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Directions to “ DAILEN PEREZ MEDERO ” Practice Location

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