Provider Demographics
NPI:1518066596
Name:PEREZ, ROMARICO (MS)
Entity Type:Individual
Prefix:
First Name:ROMARICO
Middle Name:
Last Name:PEREZ
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 W 66 ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012
Mailing Address - Country:US
Mailing Address - Phone:786-252-9439
Mailing Address - Fax:305-231-6294
Practice Address - Street 1:701 SW 27TH AVE
Practice Address - Street 2:SUITE G20
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-3031
Practice Address - Country:US
Practice Address - Phone:305-643-7800
Practice Address - Fax:305-643-1345
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9409101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health