MEDICARE: MISS MARTHA ISABEL PEREZ BCABA

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	106E00000X	Assistant Behavior Analyst	0-13-5428	FL

General Provider Information

NPI Number	:	1851696793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS MARTHA ISABEL PEREZ BCABA

Provider Business Mailing Address
First Line	:	3045 SW 5TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33135-2705
Country	:	US
Telephone Number	:	305-281-0409
Fax Number	:

Provider Business Practice Location Address
First Line	:	450 N PARK RD STE 400
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-6918
Country	:	US
Telephone Number	:	954-925-3191
Fax Number	:

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

Provider Enumeration Date	:	01/25/2011
Last Update Date	:	04/29/2025

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