MEDICARE: CARLOS JAVIER PEREZ CARRERA

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	106E00000X	Assistant Behavior Analyst	0-26-16901

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215713573
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLOS JAVIER PEREZ CARRERA

Provider Business Mailing Address
First Line	:	882 PIPERS CAY DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33415-4011
Country	:	US
Telephone Number	:	561-706-0390
Fax Number	:

Provider Business Practice Location Address
First Line	:	882 PIPERS CAY DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33415-4011
Country	:	US
Telephone Number	:	561-706-0390
Fax Number	:

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

Provider Enumeration Date	:	09/04/2023
Last Update Date	:	07/01/2026

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