Provider Demographics
NPI:1225486889
Name:PEREZ LLANES, BARBARA A
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:PEREZ LLANES
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 1:12275 NW 99TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-2969
Mailing Address - Country:US
Mailing Address - Phone:786-419-8610
Mailing Address - Fax:
Practice Address - Street 1:12275 NW 99TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-2969
Practice Address - Country:US
Practice Address - Phone:786-419-8610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-24
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-16-16132106S00000X
222Q00000X, 247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other