Healthcare Provider Details

I. General information

NPI: 1215500202
Provider Name (Legal Business Name): JEYGRIS PERERA GUTIERREZ RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2021
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

853 E 24TH ST APT 203
HIALEAH FL
33013-4243
US

IV. Provider business mailing address

853 E 24TH ST APT 203
HIALEAH FL
33013-4243
US

V. Phone/Fax

Practice location:
  • Phone: 786-212-9075
  • Fax:
Mailing address:
  • Phone: 786-212-9075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: