MEDICARE: GISELLE CALERO PEREZ BCBA

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	0-20-11375	FL
2	106S00000X	Behavior Technician	20-1580-212222	FL
3	103K00000X	Behavior Analyst	1-21-50697	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	:	1881218238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GISELLE CALERO PEREZ BCBA

Provider Business Mailing Address
First Line	:	4361 SW 129TH PL
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-4042
Country	:	US
Telephone Number	:	786-486-3365
Fax Number	:

Provider Business Practice Location Address
First Line	:	4684 SW 164TH PL
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33185-5268
Country	:	US
Telephone Number	:	786-486-3365
Fax Number	:

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

Provider Enumeration Date	:	06/02/2020
Last Update Date	:	10/17/2024

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Directions to “ GISELLE CALERO PEREZ BCBA” Practice Location

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