Provider Demographics
NPI:1326556275
Name:DIOS PEREZ, YANET
Entity Type:Individual
Prefix:
First Name:YANET
Middle Name:
Last Name:DIOS PEREZ
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 1:15329 SW 123RD AVE APT 329
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-6807
Mailing Address - Country:US
Mailing Address - Phone:305-504-1726
Mailing Address - Fax:
Practice Address - Street 1:15329 SW 123RD AVE APT 329
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-6807
Practice Address - Country:US
Practice Address - Phone:305-504-1726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBCABA0199531106E00000X
FLRBT1865357106S00000X
FLBCBA1-20-44524103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician