Provider Demographics
NPI:1184262818
Name:PEREZ LUJAN, DALGYS
Entity type:Individual
Prefix:
First Name:DALGYS
Middle Name:
Last Name:PEREZ LUJAN
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 1:14241 SW 96TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-7894
Mailing Address - Country:US
Mailing Address - Phone:305-457-2449
Mailing Address - Fax:
Practice Address - Street 1:70 NW 6TH ST FL 1
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-5934
Practice Address - Country:US
Practice Address - Phone:786-601-7887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-12
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH17591101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health