Provider Demographics
NPI:1508178351
Name:PEREZ, RAYMOND A SR (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:A
Last Name:PEREZ
Suffix:SR
Gender:M
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9965 SW 157TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-1690
Mailing Address - Country:US
Mailing Address - Phone:305-244-6040
Mailing Address - Fax:
Practice Address - Street 1:9965 SW 157TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-1690
Practice Address - Country:US
Practice Address - Phone:305-244-6040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-09
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 13776225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist