Healthcare Provider Details

I. General information

NPI: 1073479044
Provider Name (Legal Business Name): SUSANA PEREZ GUILLOT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7006 SIERRA MADRE PL APT 202
TAMPA FL
33617-8872
US

IV. Provider business mailing address

7006 SIERRA MADRE PL APT 202
TAMPA FL
33617-8872
US

V. Phone/Fax

Practice location:
  • Phone: 813-953-9452
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: