Provider Demographics
NPI:1720536634
Name:PEREZ, CLAUDIA DE LAS MERCEDES
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:DE LAS MERCEDES
Last Name:PEREZ
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 1:9870 SW 223RD TER
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33190-1582
Mailing Address - Country:US
Mailing Address - Phone:786-344-0658
Mailing Address - Fax:
Practice Address - Street 1:9870 SW 223RD TER
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33190-1582
Practice Address - Country:US
Practice Address - Phone:786-344-0658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No126800000XDental ProvidersDental Assistant