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General NPI Number Information
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NPI Number | 1437365541
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Entity Type | Individual
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Provider Name | TRACY PEREZ PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 09/12/2011
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Provider Practice Location Address
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Address Line | 2900 W CYPRESS CREEK RD SUITE 3
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City | FT LAUDERDALE
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State | FL
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Zip | 33309-1715
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Country | US
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Telephone | 954-601-1930
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Fax | 954-601-1399
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Provider Business Mailing Address
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Address Line | 2900 W CYPRESS CREEK RD SUITE 3
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City | FT LAUDERDALE
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State | FL
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Zip | 33309-1715
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Country | US
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Telephone | 954-601-1930
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Fax | 954-601-1399
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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 | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State | FL
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