Provider Demographics
NPI:1518639194
Name:PEREZ, FREDDY F
Entity type:Individual
Prefix:
First Name:FREDDY
Middle Name:F
Last Name: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 1:717 PONCE DE LEON BLVD STE 323A
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2050
Mailing Address - Country:US
Mailing Address - Phone:786-580-1165
Mailing Address - Fax:
Practice Address - Street 1:717 PONCE DE LEON BLVD STE 323A
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2050
Practice Address - Country:US
Practice Address - Phone:786-580-1165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-01
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst