Provider Demographics
NPI:1114040722
Name:PEREZ-BERMUDEZ, DIANELYS (OTR)
Entity Type:Individual
Prefix:MRS
First Name:DIANELYS
Middle Name:
Last Name:PEREZ-BERMUDEZ
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6955 N. W. 186 STREET
Mailing Address - Street 2:APT. 201
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33015
Mailing Address - Country:US
Mailing Address - Phone:305-300-1259
Mailing Address - Fax:305-261-5669
Practice Address - Street 1:7815 SW 24TH ST
Practice Address - Street 2:SUITE 109
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-6541
Practice Address - Country:US
Practice Address - Phone:305-261-5664
Practice Address - Fax:305-261-5669
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT10375225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist