Provider Demographics
NPI:1922171313
Name:PEREZ-DUSEK, GERTRUDIS (PSYD)
Entity Type:Individual
Prefix:DR
First Name:GERTRUDIS
Middle Name:
Last Name:PEREZ-DUSEK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6524 PELICAN AVE
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-2423
Mailing Address - Country:US
Mailing Address - Phone:954-571-0253
Mailing Address - Fax:786-246-4247
Practice Address - Street 1:8280 NW 27TH ST
Practice Address - Street 2:SUITE 511
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33122-1927
Practice Address - Country:US
Practice Address - Phone:305-718-3712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 5017101YM0800X
FLPY 6487103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical