Provider Demographics
NPI:1427588425
Name:PEREZ, LESTER ALEJANDRO
Entity Type:Individual
Prefix:
First Name:LESTER
Middle Name:ALEJANDRO
Last Name:PEREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8900 SW 172ND AVE APT 2302
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-3052
Mailing Address - Country:US
Mailing Address - Phone:305-310-4404
Mailing Address - Fax:
Practice Address - Street 1:8900 SW 172ND AVE APT 2302
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-3052
Practice Address - Country:US
Practice Address - Phone:305-310-4404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-13
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
FL1-21-55961103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician