MEDICARE: BELKIS PEREZ BA

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

General Provider Information

NPI Number	:	1124578067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BELKIS PEREZ BA

Provider Business Mailing Address
First Line	:	1600 N 68TH AVE
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-5724
Country	:	US
Telephone Number	:	786-620-4619
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 N 68TH AVE
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-5724
Country	:	US
Telephone Number	:	786-620-4619
Fax Number	:

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

Provider Enumeration Date	:	10/04/2016
Last Update Date	:	01/20/2026

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Directions to “ BELKIS PEREZ BA” Practice Location

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