MEDICARE: SANDRA DE LA CARIDAD PEREZ GOMEZ

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	:	1306635644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA DE LA CARIDAD PEREZ GOMEZ

Provider Business Mailing Address
First Line	:	465 E 28TH ST APT 5
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33013-3663
Country	:	US
Telephone Number	:	629-772-9753
Fax Number	:

Provider Business Practice Location Address
First Line	:	465 E 28TH ST APT 5
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33013-3663
Country	:	US
Telephone Number	:	629-772-9753
Fax Number	:	629-772-9753

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

Provider Enumeration Date	:	05/03/2025
Last Update Date	:	05/03/2025

Similar Medicare Providers

1881577674 — REYLANDI GONZALEZ IGLESIAS
Practice Location Address:

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1306544457 — MAHELIS NAVEIRA CRUZ
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1811776073 — YITSY DUARDO ALCANTARA
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1336093665 — YUDENIS HORTA HECHAVARRIA
Practice Location Address:

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1609720770 — JULEMAN C HERNANDEZ ESPINOSA
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Directions to “ SANDRA DE LA CARIDAD PEREZ GOMEZ ” Practice Location

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