Provider Demographics
NPI:1184468829
Name:PEREZ ROSALES, DUNAY
Entity type:Individual
Prefix:
First Name:DUNAY
Middle Name:
Last Name:PEREZ ROSALES
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 1:16969 SW 94TH CT
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-4428
Mailing Address - Country:US
Mailing Address - Phone:786-312-8053
Mailing Address - Fax:
Practice Address - Street 1:16969 SW 94TH CT
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-4428
Practice Address - Country:US
Practice Address - Phone:786-312-8053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-24-350731106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician