Healthcare Provider Details

I. General information

NPI: 1366268567
Provider Name (Legal Business Name): SAILYN WANDA PEREZ RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2024
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8140 COLLEGE PKWY STE 107
FORT MYERS FL
33919-4111
US

IV. Provider business mailing address

1028 NW 15TH PL
CAPE CORAL FL
33993-7224
US

V. Phone/Fax

Practice location:
  • Phone: 239-360-7963
  • Fax: 239-360-7967
Mailing address:
  • Phone: 239-896-5508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-393948
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: