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General NPI Number Information
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NPI Number | 1164993614
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Entity Type | Individual
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Provider Name | NANCY PEREZ GONZALEZ
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Gender | Female
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Dates
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Enumeration Date | 12/10/2018
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Last Update Date | 08/31/2020
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Provider Practice Location Address
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Address Line | 331 SWALLOW DR APT 19
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City | MIAMI SPRINGS
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State | FL
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Zip | 33166-4467
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Country | US
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Telephone | 305-316-6075
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Fax |
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Provider Business Mailing Address
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Address Line | 15862 SW 84TH ST
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City | MIAMI
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State | FL
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Zip | 33193-5227
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Country | US
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Telephone | 305-316-6075
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | BCBA1-20-43425
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License Number State | FL
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