Healthcare Provider Details

I. General information

NPI: 1942706700
Provider Name (Legal Business Name): VERONIKA HURTADO PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2018
Last Update Date: 07/18/2024
Certification Date: 07/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2724 LINCOLN ST
HOLLYWOOD FL
33020-3846
US

IV. Provider business mailing address

2724 LINCOLN ST
HOLLYWOOD FL
33020-3846
US

V. Phone/Fax

Practice location:
  • Phone: 786-219-5331
  • Fax:
Mailing address:
  • Phone: 786-219-5331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-24-74283
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-21-13072
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: