Provider Demographics
NPI:1134975725
Name:PEREZ ARMAS, REGLA DE LAS MERCEDES
Entity type:Individual
Prefix:
First Name:REGLA
Middle Name:DE LAS MERCEDES
Last Name:PEREZ ARMAS
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 1:5273 NW 5TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-5033
Mailing Address - Country:US
Mailing Address - Phone:786-487-1987
Mailing Address - Fax:
Practice Address - Street 1:5273 NW 5TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-5033
Practice Address - Country:US
Practice Address - Phone:786-487-1987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-394919106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty