Healthcare Provider Details

I. General information

NPI: 1013731611
Provider Name (Legal Business Name): NATALIE NICOLE PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2024
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19001 SW 106TH AVE STE 107
CUTLER BAY FL
33157-7671
US

IV. Provider business mailing address

13272 SW 119TH TER # TRR
MIAMI FL
33186-4554
US

V. Phone/Fax

Practice location:
  • Phone: 305-378-5775
  • Fax:
Mailing address:
  • Phone: 305-399-2863
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-389705
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: