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General NPI Number Information
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NPI Number | 1891257614
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Entity Type | Individual
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Provider Name | JEYVI PEREZ CORDOVA
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Gender | Female
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Dates
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Enumeration Date | 04/01/2019
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Last Update Date | 11/04/2019
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Provider Practice Location Address
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Address Line | 9059 SW 141ST PL APT 9059
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City | MIAMI
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State | FL
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Zip | 33186-1284
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Country | US
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Telephone | 305-509-9654
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Fax |
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Provider Business Mailing Address
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Address Line | 4425 OCEAN BREEZE AVE
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89031-0221
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Country | US
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Telephone |
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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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