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General NPI Number Information
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NPI Number | 1619452638
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Entity Type | Individual
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Provider Name | JENNY PEREZ RBT-18-66112
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Gender | Female
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Dates
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Enumeration Date | 09/25/2018
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 18245 PAULSON DR STE 104
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City | PORT CHARLOTTE
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State | FL
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Zip | 33954-1019
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Country | US
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Telephone | 786-217-2040
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Fax |
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Provider Business Mailing Address
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Address Line | 636 SE 13TH PL APT 1
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City | CAPE CORAL
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State | FL
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Zip | 33990-2610
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Country | US
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Telephone | 786-217-2040
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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