Provider Demographics
NPI:1629585773
Name:PERRY-DIAZ, ANILEIDY C
Entity type:Individual
Prefix:
First Name:ANILEIDY
Middle Name:C
Last Name:PERRY-DIAZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12220 TOWNE LAKE DR STE 1
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33913-8021
Mailing Address - Country:US
Mailing Address - Phone:239-433-6700
Mailing Address - Fax:
Practice Address - Street 1:12220 TOWNE LAKE DR STE 1
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33913-8021
Practice Address - Country:US
Practice Address - Phone:239-433-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-10
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker