Healthcare Provider Details

I. General information

NPI: 1972556124
Provider Name (Legal Business Name): FRANK ROBERTO PEREZ VERDECIA PSY.D., LMHC, BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: FRANK R. PEREZ PSY.D.

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 08/08/2024
Certification Date: 08/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 PONCE DE LEON BLVD STE 1201
CORAL GABLES FL
33134-4476
US

IV. Provider business mailing address

2020 PONCE DE LEON BLVD STE 1201
CORAL GABLES FL
33134-4476
US

V. Phone/Fax

Practice location:
  • Phone: 305-917-5414
  • Fax: 305-220-1864
Mailing address:
  • Phone: 305-917-5414
  • Fax: 305-220-1864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH10722
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPY8713
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberPY8713
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberPY7813
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBCBA11830222
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License NumberPY8713
License Number StateFL
# 7
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License NumberPY8713
License Number StateFL
# 8
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPY8713
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: