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General NPI Number Information
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NPI Number | 1205688850
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Entity Type | Individual
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Provider Name | MICHAEL ANTHONY PEREZ
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Gender | Male
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Dates
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Enumeration Date | 04/04/2024
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Last Update Date | 05/06/2024
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Provider Practice Location Address
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Address Line | 13700 58TH ST N
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City | CLEARWATER
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State | FL
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Zip | 33760-3757
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Country | US
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Telephone | 727-223-3545
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Fax |
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Provider Business Mailing Address
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Address Line | 4932 GETNER ST
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652-3441
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Country | US
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Telephone | 917-470-6178
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0101139
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License Number State | FL
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