Provider Demographics
NPI:1639424781
Name:PEREZ, ROMY (RCSWI)
Entity Type:Individual
Prefix:
First Name:ROMY
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:RCSWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4343 W FLAGLER ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1585
Mailing Address - Country:US
Mailing Address - Phone:305-774-9570
Mailing Address - Fax:
Practice Address - Street 1:4343 W FLAGLER ST STE 100
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1585
Practice Address - Country:US
Practice Address - Phone:305-774-9570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-16
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL58811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical