Provider Demographics
NPI:1861072753
Name:HERNANDEZ PEREZ, ABEL (BCBA)
Entity type:Individual
Prefix:
First Name:ABEL
Middle Name:
Last Name:HERNANDEZ PEREZ
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:536 SW 47TH ST APT B
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33914-6679
Mailing Address - Country:US
Mailing Address - Phone:786-616-1804
Mailing Address - Fax:
Practice Address - Street 1:536 SW 47TH ST APT B
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33914-6679
Practice Address - Country:US
Practice Address - Phone:786-616-1804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-13
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-144840106S00000X
FL1-21-52869103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician