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General NPI Number Information
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NPI Number | 1720823925
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Entity Type | Individual
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Provider Name | FERNANDO CAMILO PEREZ DEL VALLE
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Gender | Male
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Dates
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Enumeration Date | 06/28/2024
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Last Update Date | 06/28/2024
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Provider Practice Location Address
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Address Line | 1941 SW 2ND ST APT 5
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City | MIAMI
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State | FL
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Zip | 33135-1747
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Country | US
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Telephone | 786-515-4512
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Fax |
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Provider Business Mailing Address
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Address Line | 777 NW 72ND AVE STE 1083
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City | MIAMI
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State | FL
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Zip | 33126-3176
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Country | US
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Telephone | 305-342-7643
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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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