Provider Demographics
NPI:1942074273
Name:PEREZ DEL TORO, ANIA R
Entity Type:Individual
Prefix:
First Name:ANIA
Middle Name:R
Last Name:PEREZ DEL TORO
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 1:14203 ALAMANDA AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2908
Mailing Address - Country:US
Mailing Address - Phone:407-866-7580
Mailing Address - Fax:
Practice Address - Street 1:14203 ALAMANDA AVE
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2908
Practice Address - Country:US
Practice Address - Phone:407-866-7580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-304602106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty