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General NPI Number Information
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NPI Number | 1306266754
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Entity Type | Individual
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Provider Name | MICHELE AGUSTINA PEREZ
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Gender | Female
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Dates
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Enumeration Date | 04/24/2014
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Last Update Date | 09/20/2024
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Provider Practice Location Address
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Address Line | 1801 NE 21ST PL
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City | CAPE CORAL
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State | FL
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Zip | 33909-4608
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Country | US
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Telephone | 786-712-7081
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Fax | 239-457-1008
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Provider Business Mailing Address
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Address Line | 1801 NE 21ST PL
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City | CAPE CORAL
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State | FL
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Zip | 33909-4608
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Country | US
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Telephone | 786-712-7081
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Fax | 239-457-1008
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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 | 1-21-53727
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License Number State | FL
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