Healthcare Provider Details

I. General information

NPI: 1962369587
Provider Name (Legal Business Name): MARLON RADAMES PEREZ CONTRERAS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

4742 ALTIS DR
NAPLES FL
34104-5534
US

IV. Provider business mailing address

1730 SUNSHINE BLVD
NAPLES FL
34116-6050
US

V. Phone/Fax

Practice location:
  • Phone: 239-378-6307
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-502124
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: