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General NPI Number Information
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NPI Number | 1760898266
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Entity Type | Individual
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Provider Name | ROLANDO PEREZ LCSW
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Gender | Male
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Dates
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Enumeration Date | 07/03/2014
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Last Update Date | 03/27/2023
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Provider Practice Location Address
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Address Line | 4685 S CONGRESS AVE
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City | PALM SPRINGS
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State | FL
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Zip | 33461-4761
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Country | US
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Telephone | 772-361-8887
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Fax |
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Provider Business Mailing Address
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Address Line | 4685 S. CONGRESS AVENUE
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City | LAKE WORTH
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State | FL
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Zip | 33461-4761
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Country | US
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Telephone | 723-618-8887
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 091704
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW14929
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License Number State | FL
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