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General NPI Number Information
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NPI Number | 1104174093
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Entity Type | Individual
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Provider Name | JANICE PEREZ RIVERA LMHC
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Gender | Female
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Dates
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Enumeration Date | 08/27/2012
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Last Update Date | 08/17/2024
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Provider Practice Location Address
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Address Line | 1211 TECH BLVD
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City | TAMPA
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State | FL
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Zip | 33619-7846
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Country | US
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Telephone | 813-708-7869
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Fax |
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Provider Business Mailing Address
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Address Line | 10929 WHITECAP DR
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City | RIVERVIEW
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State | FL
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Zip | 33579-7177
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Country | US
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Telephone | 727-277-2585
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Fax | 813-490-5495
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH23735
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License Number State | FL
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