Healthcare Provider Details

I. General information

NPI: 1841803152
Provider Name (Legal Business Name): MARIA K PEREZ GAYOSO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2020
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16502 SW 68TH TER
MIAMI FL
33193-5530
US

IV. Provider business mailing address

16502 SW 68TH TER
MIAMI FL
33193-5530
US

V. Phone/Fax

Practice location:
  • Phone: 786-862-4637
  • Fax:
Mailing address:
  • Phone: 786-862-4637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2852287
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: