Provider Demographics
NPI:1336037134
Name:PEREZ TAMAYO, CARLOS MIGUEL (RBT-25-448711)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:MIGUEL
Last Name:PEREZ TAMAYO
Suffix:
Gender:M
Credentials:RBT-25-448711
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1158 SE 23RD AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33035-2143
Mailing Address - Country:US
Mailing Address - Phone:786-731-0377
Mailing Address - Fax:
Practice Address - Street 1:1158 SE 23RD AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33035-2143
Practice Address - Country:US
Practice Address - Phone:786-731-0377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-448711103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst