Healthcare Provider Details

I. General information

NPI: 1427084359
Provider Name (Legal Business Name): MARIO PEREZ LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3850 W FLAGLER ST
CORAL GABLES FL
33134-1604
US

IV. Provider business mailing address

2300 NW 89TH PL FL 3
DORAL FL
33172-2431
US

V. Phone/Fax

Practice location:
  • Phone: 305-774-3300
  • Fax:
Mailing address:
  • Phone: 305-398-6100
  • Fax: 305-774-3355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH9282
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: