Healthcare Provider Details

I. General information

NPI: 1013840933
Provider Name (Legal Business Name): CHRISTINA PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14160 PALMETTO FRNTG RD STE 115
MIAMI LAKES FL
33016-1641
US

IV. Provider business mailing address

2970 NW 96TH ST
MIAMI FL
33147-2338
US

V. Phone/Fax

Practice location:
  • Phone: 305-491-9169
  • Fax:
Mailing address:
  • Phone: 786-380-3365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSI8778
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: