MEDICARE: JESSICA PEREZ ALVAREZ

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	RBT-24-345562	FL

General Provider Information

NPI Number	:	1922857929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA PEREZ ALVAREZ

Provider Business Mailing Address
First Line	:	8300 NW 53RD ST STE 350
Second Line	:
City	:	DORAL
State	:	FL
Zip	:	33166-7712
Country	:	US
Telephone Number	:	305-342-7643
Fax Number	:

Provider Business Practice Location Address
First Line	:	429 NE 13TH ST
Second Line	:
City	:	FLORIDA CITY
State	:	FL
Zip	:	33034-4897
Country	:	US
Telephone Number	:	786-416-5122
Fax Number	:

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

Provider Enumeration Date	:	05/14/2024
Last Update Date	:	05/21/2025

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