Provider Demographics
NPI:1144944497
Name:ABREU PEREZ, ALEXEI
Entity type:Individual
Prefix:
First Name:ALEXEI
Middle Name:
Last Name:ABREU PEREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 MANOR DR
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-2946
Mailing Address - Country:US
Mailing Address - Phone:561-412-7639
Mailing Address - Fax:
Practice Address - Street 1:1045 MANOR DR
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-2946
Practice Address - Country:US
Practice Address - Phone:561-412-7639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-30
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-22-234243106S00000X
FL22-234243106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty