MEDICARE: MRS. ARLET GOMEZ 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

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	:	1861968141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ARLET GOMEZ PEREZ

Provider Business Mailing Address
First Line	:	533 SHADY PINE WAY APT C1
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33415-8940
Country	:	US
Telephone Number	:	561-729-9874
Fax Number	:

Provider Business Practice Location Address
First Line	:	15655 75TH WAY N
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33418-1851
Country	:	US
Telephone Number	:	772-463-0444
Fax Number	:	772-219-1339

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

Provider Enumeration Date	:	10/15/2018
Last Update Date	:	08/29/2022

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