Provider Demographics
NPI:1013156892
Name:PEREZ, ANA MARIA (BCABA)
Entity Type:Individual
Prefix:MRS
First Name:ANA
Middle Name:MARIA
Last Name:PEREZ
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1580 NW 93RD AVE
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-4562
Mailing Address - Country:US
Mailing Address - Phone:786-308-7444
Mailing Address - Fax:
Practice Address - Street 1:1580 NW 93RD AVE
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-4562
Practice Address - Country:US
Practice Address - Phone:786-308-7444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-18
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-03-1053103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst