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NPI Code Detail

MEDICARE: MRS. SHERRY NICOLE PEREZ

MEDICARE: MRS. SHERRY NICOLE PEREZ
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
1106S00000XBehavior TechnicianRBT-24-390653FL

General Provider Information

NPI Number : 1205659646
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHERRY NICOLE PEREZ
Provider Business Mailing Address
First Line : 1200 DEER MOSS LOOP APT 2107
Second Line :
City : NICEVILLE
State : FL
Zip : 32578-3448
Country : US
Telephone Number : 843-227-0098
Fax Number :
Provider Business Practice Location Address
First Line : 1001 INDUSTRIAL DR
Second Line :
City : CRESTVIEW
State : FL
Zip : 32539-6943
Country : US
Telephone Number : 850-400-6098
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2024
Last Update Date : 11/04/2024

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Directions to “ MRS. SHERRY NICOLE PEREZ ” Practice Location

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