Provider Demographics
NPI:1720965692
Name:PERDOMO ALVARINO, NATALIA
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:PERDOMO ALVARINO
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 1:511 CULTURAL PARK BLVD S FL USA
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-1213
Mailing Address - Country:US
Mailing Address - Phone:786-428-7242
Mailing Address - Fax:
Practice Address - Street 1:511 CULTURAL PARK BLVD S FL USA
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-1213
Practice Address - Country:US
Practice Address - Phone:786-428-7242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician