Provider Demographics
NPI:1427577170
Name:PEREZ, ARLISS KARIM (PTA)
Entity Type:Individual
Prefix:
First Name:ARLISS
Middle Name:KARIM
Last Name:PEREZ
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1674 BOBTAIL DR
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-8608
Mailing Address - Country:US
Mailing Address - Phone:407-591-0235
Mailing Address - Fax:
Practice Address - Street 1:3355 E SEMORAN BLVD
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-6062
Practice Address - Country:US
Practice Address - Phone:407-862-6263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-13
Last Update Date:2017-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25644225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant