Provider Demographics
NPI:1710589874
Name:PEREZ, ANGEL M (LMFT)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:M
Last Name:PEREZ
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3149 MANDEVILLE ST
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32738-2100
Mailing Address - Country:US
Mailing Address - Phone:520-499-0366
Mailing Address - Fax:
Practice Address - Street 1:3149 MANDEVILLE ST
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32738-2100
Practice Address - Country:US
Practice Address - Phone:520-499-0366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor