Provider Demographics
NPI:1528415569
Name:PEREZ MAURA, KAREL E (RBT)
Entity Type:Individual
Prefix:
First Name:KAREL
Middle Name:E
Last Name:PEREZ MAURA
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 S ROYAL POINCIANA BLVD PH 4
Mailing Address - Street 2:
Mailing Address - City:MIAMI SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33166-7322
Mailing Address - Country:US
Mailing Address - Phone:305-586-8948
Mailing Address - Fax:
Practice Address - Street 1:801 S ROYAL POINCIANA BLVD PH 4
Practice Address - Street 2:
Practice Address - City:MIAMI SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33166
Practice Address - Country:US
Practice Address - Phone:305-586-8948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-19
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-15-02243106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017497900Medicaid
RBT-15-02243OtherBEHAVIOR ANALYST CERTIFICATION BOARD