MEDICARE: LIUTMILA PEREZ GIL RBT-23-310380

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-23-310380	FL

General Provider Information

NPI Number	:	1356118095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIUTMILA PEREZ GIL RBT-23-310380

Provider Business Mailing Address
First Line	:	2912 NW 49TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33142-3557
Country	:	US
Telephone Number	:	305-540-7612
Fax Number	:

Provider Business Practice Location Address
First Line	:	2912 NW 49TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33142-3557
Country	:	US
Telephone Number	:	305-540-7612
Fax Number	:

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

Provider Enumeration Date	:	12/04/2023
Last Update Date	:	12/04/2023

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