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NPI Code Detail

MEDICARE: VANESSA SOFIA PERTUZ

MEDICARE: VANESSA SOFIA PERTUZ
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
1106E00000XAssistant Behavior Analyst0-25-15984FL
2103K00000XBehavior Analyst
3106S00000XBehavior Technician

Other Identifiers

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

General Provider Information

NPI Number : 1821734674
Entity Type Code : Individual
Provider Name (Legal Business Name) : VANESSA SOFIA PERTUZ
Provider Business Mailing Address
First Line : 350 FAIRWAY DR STE 101
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33441-1834
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10004 N DALE MABRY HWY STE 102
Second Line :
City : TAMPA
State : FL
Zip : 33618-4421
Country : US
Telephone Number : 888-880-9270
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2022
Last Update Date : 01/13/2026

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1184415945 — MIA WOODEN-WILLIAMS
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1508720368 — ZOE EASON
Practice Location Address:
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TAMPA, FL
33618-4421
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Practice Fax:
1811854425 — MR. ANTONIO ANDRES CHEN
Practice Location Address:
10004 N DALE MABRY HWY STE 102
TAMPA, FL
33618-4421
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Practice Fax:

Directions to “ VANESSA SOFIA PERTUZ ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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