Provider Demographics
NPI:1073033510
Name:PEREZ, YASMANI
Entity Type:Individual
Prefix:
First Name:YASMANI
Middle Name:
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 1:245 NE 14TH ST APT 3409
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33132-1636
Mailing Address - Country:US
Mailing Address - Phone:305-923-4168
Mailing Address - Fax:
Practice Address - Street 1:245 NE 14TH ST APT 3409
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33132-1636
Practice Address - Country:US
Practice Address - Phone:305-923-4168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician