Provider Demographics
NPI:1144417833
Name:PEREZ, HECTOR JR (PTA)
Entity Type:Individual
Prefix:MR
First Name:HECTOR
Middle Name:
Last Name:PEREZ
Suffix:JR
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2916 WATERFORD DR S
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-5971
Mailing Address - Country:US
Mailing Address - Phone:561-271-7475
Mailing Address - Fax:
Practice Address - Street 1:2916 WATERFORD DR S
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-5971
Practice Address - Country:US
Practice Address - Phone:561-271-7475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA # 19304225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant