MEDICARE: YISELL MARRON 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
1	106S00000X	Behavior Technician	RBT-21-187964	FL
2	106E00000X	Assistant Behavior Analyst	0-26-16791	FL

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	:	1346902673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YISELL MARRON PEREZ

Provider Business Mailing Address
First Line	:	1434 KIRK RD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-4964
Country	:	US
Telephone Number	:	561-779-2107
Fax Number	:

Provider Business Practice Location Address
First Line	:	1495 FOREST HILL BLVD STE C3
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-6073
Country	:	US
Telephone Number	:	561-568-9367
Fax Number	:

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

Provider Enumeration Date	:	10/13/2021
Last Update Date	:	01/12/2026

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Directions to “ YISELL MARRON PEREZ ” Practice Location

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