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General NPI Number Information
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NPI Number | 1114525276
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Entity Type | Individual
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Provider Name | JORGE ALBERTO PEREZ MOLINA TH.M.
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Gender | Male
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Dates
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Enumeration Date | 10/12/2020
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Last Update Date | 10/12/2020
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Provider Practice Location Address
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Address Line | 518 PEACHTREE RD
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City | ORLANDO
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State | FL
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Zip | 32804-6813
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Country | US
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Telephone | 407-730-7983
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Fax |
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Provider Business Mailing Address
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Address Line | 4924 EAGLESMERE DR APT 337
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City | ORLANDO
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State | FL
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Zip | 32819-5621
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Country | US
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Telephone | 407-766-0694
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Fax |
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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 | 225XM0800X
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Taxonomy Name | Mental Health Occupational Therapist
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225XM0800X
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Taxonomy Name | Mental Health Occupational Therapist
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License Number |
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License Number State |
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