Healthcare Provider Details

I. General information

NPI: 1285211987
Provider Name (Legal Business Name): JESSICA PEREZ SANCHEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2021
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2860 NW 185TH ST
MIAMI GARDENS FL
33056-3152
US

IV. Provider business mailing address

2860 NW 185TH ST
MIAMI GARDENS FL
33056-3152
US

V. Phone/Fax

Practice location:
  • Phone: 305-988-3704
  • Fax:
Mailing address:
  • Phone: 305-988-3704
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-21-160584
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: