MEDICARE: MRS. ANA MARIA PEREZ BCABA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	0-03-1053	FL

General Provider Information

NPI Number	:	1013156892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANA MARIA PEREZ BCABA

Provider Business Mailing Address
First Line	:	1580 NW 93RD AVE
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33024-4562
Country	:	US
Telephone Number	:	786-308-7444
Fax Number	:

Provider Business Practice Location Address
First Line	:	1580 NW 93RD AVE
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33024-4562
Country	:	US
Telephone Number	:	786-308-7444
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/18/2009
Last Update Date	:	02/18/2009

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