Provider Demographics
NPI:1972851319
Name:PEREZ, ANN MARIE (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ANN MARIE
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8315 SW 206TH TER
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-2627
Mailing Address - Country:US
Mailing Address - Phone:305-790-1915
Mailing Address - Fax:
Practice Address - Street 1:7800 S RED RD STE 205
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5542
Practice Address - Country:US
Practice Address - Phone:305-854-2471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ6008235Z00000X
FLSA12379235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist