MEDICARE: LIMITLESS D PEREZ LLC

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1265205744
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIMITLESS D PEREZ LLC

Provider Business Mailing Address
First Line	:	15992 NE 19TH PL
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-5716
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15992 NE 19TH PL
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-5716
Country	:	US
Telephone Number	:	786-916-9910
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DAINELYS PEREZ
Credential	:
Telephone Number	:	786-916-9910

Provider Enumeration Date	:	11/06/2023
Last Update Date	:	11/06/2023

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