MEDICARE: LEONIDES 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	101YM0800X	Mental Health Counselor	MH16076	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	:	1871974774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEONIDES PEREZ

Provider Business Mailing Address
First Line	:	3216 CARAMBOLA CIR S
Second Line	:
City	:	COCONUT CREEK
State	:	FL
Zip	:	33066-2144
Country	:	US
Telephone Number	:	305-801-3424
Fax Number	:

Provider Business Practice Location Address
First Line	:	3216 CARAMBOLA CIR S
Second Line	:
City	:	COCONUT CREEK
State	:	FL
Zip	:	33066-2144
Country	:	US
Telephone Number	:	305-801-3424
Fax Number	:

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

Provider Enumeration Date	:	06/16/2015
Last Update Date	:	04/16/2026

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Directions to “ LEONIDES PEREZ ” Practice Location

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