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General NPI Number Information
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NPI Number | 1023327350
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Entity Type | Individual
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Provider Name | SEIDA PEREZ LMHC
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Gender | Female
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Dates
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Enumeration Date | 10/05/2010
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Last Update Date | 12/08/2016
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Provider Practice Location Address
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Address Line | 36739 SR 52 SUITE 207B
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City | DADE CITY
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State | FL
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Zip | 33525
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Country | US
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Telephone | 813-712-0188
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Fax | 813-618-3945
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Provider Business Mailing Address
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Address Line | 36739 STATE ROAD 52 SUITE 207B
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City | DADE CITY
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State | FL
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Zip | 33525-5101
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Country | US
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Telephone | 813-712-0188
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Fax | 813-618-3945
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH12740
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License Number State | FL
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