Provider Demographics
NPI:1073367694
Name:PEREZ SOCARRAS, DAYMI
Entity Type:Individual
Prefix:
First Name:DAYMI
Middle Name:
Last Name:PEREZ SOCARRAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6034 CRESTRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-4922
Mailing Address - Country:US
Mailing Address - Phone:656-347-8125
Mailing Address - Fax:
Practice Address - Street 1:6034 CRESTRIDGE RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-4922
Practice Address - Country:US
Practice Address - Phone:656-347-8125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-337741106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician