MEDICARE: ADELEISY D PEREZ RBT

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	BACB862241	FL

General Provider Information

NPI Number	:	1982386215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADELEISY D PEREZ RBT

Provider Business Mailing Address
First Line	:	6024 SW 8TH ST LOT E500
Second Line	:
City	:	WEST MIAMI
State	:	FL
Zip	:	33144-5066
Country	:	US
Telephone Number	:	305-613-6718
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 NE 95TH ST
Second Line	:
City	:	MIAMI SHORES
State	:	FL
Zip	:	33138-2564
Country	:	US
Telephone Number	:	305-519-2855
Fax Number	:

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

Provider Enumeration Date	:	08/04/2023
Last Update Date	:	05/21/2024

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Directions to “ ADELEISY D PEREZ RBT” Practice Location

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