Provider Demographics
NPI:1013298520
Name:PEREZ, JOSE (BA)
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:
Last Name:PEREZ
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13899 BISCAYNE BLVD
Mailing Address - Street 2:# 223
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33181-1600
Mailing Address - Country:US
Mailing Address - Phone:305-244-0971
Mailing Address - Fax:
Practice Address - Street 1:13899 BISCAYNE BLVD
Practice Address - Street 2:# 223
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33181-1600
Practice Address - Country:US
Practice Address - Phone:305-244-0971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker