Provider Demographics
NPI:1235994187
Name:PEREZ COLON, INEZHA
Entity Type:Individual
Prefix:
First Name:INEZHA
Middle Name:
Last Name:PEREZ COLON
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 1:3861 CABO ROJO DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34772-8373
Mailing Address - Country:US
Mailing Address - Phone:787-981-1647
Mailing Address - Fax:407-307-2328
Practice Address - Street 1:1416 SIMPSON RD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-4600
Practice Address - Country:US
Practice Address - Phone:132-144-2992
Practice Address - Fax:407-307-2328
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty