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NPI Code Detail

MEDICARE: MIGUEL PEREZ HERNANDEZ

MEDICARE: MIGUEL PEREZ HERNANDEZ
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 : 1265967236
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIGUEL PEREZ HERNANDEZ
Provider Business Mailing Address
First Line : 4331 MARILYN DR
Second Line :
City : LAKE WORTH
State : FL
Zip : 33461-2332
Country : US
Telephone Number : 561-801-6168
Fax Number :
Provider Business Practice Location Address
First Line : 4331 MARILYN DR
Second Line :
City : LAKE WORTH
State : FL
Zip : 33461-2332
Country : US
Telephone Number : 561-801-6168
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2017
Last Update Date : 04/26/2017

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Directions to “ MIGUEL PEREZ HERNANDEZ ” Practice Location

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