Healthcare Provider Details

I. General information

NPI: 1437770732
Provider Name (Legal Business Name): MARIA CENTENO PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2020
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 NW 153RD ST STE 201
MIAMI LAKES FL
33014-2421
US

IV. Provider business mailing address

17971 NW 87TH CT
HIALEAH FL
33018-6715
US

V. Phone/Fax

Practice location:
  • Phone: 786-390-6192
  • Fax:
Mailing address:
  • Phone: 786-332-7363
  • 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: