Healthcare Provider Details

I. General information

NPI: 1831782168
Provider Name (Legal Business Name): MELISSA DIAZ PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2021
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1280 W 35TH ST
RIVIERA BEACH FL
33404-2918
US

IV. Provider business mailing address

6914 BRISBANE CT STE 200
SUGAR LAND TX
77479-4924
US

V. Phone/Fax

Practice location:
  • Phone: 512-483-1027
  • Fax:
Mailing address:
  • Phone: 512-483-1027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number02314692
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: