Healthcare Provider Details

I. General information

NPI: 1588580633
Provider Name (Legal Business Name): DANIELA PEREZ TORRES MS/CBHCM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12030 SW 129TH CT STE 103-104
MIAMI FL
33186-4583
US

IV. Provider business mailing address

16313 SW 103RD PL
MIAMI FL
33157-3159
US

V. Phone/Fax

Practice location:
  • Phone: 305-798-8784
  • Fax: 786-701-8892
Mailing address:
  • Phone: 305-798-8784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberCBHCMS.0102905
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: