Healthcare Provider Details

I. General information

NPI: 1053195735
Provider Name (Legal Business Name): ANA CLAUDIA VIGO PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2023
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2740 SW 46TH PL
FORT LAUDERDALE FL
33312-5656
US

IV. Provider business mailing address

2740 SW 46TH PL
FORT LAUDERDALE FL
33312-5656
US

V. Phone/Fax

Practice location:
  • Phone: 754-221-6303
  • Fax:
Mailing address:
  • Phone: 754-221-6303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: