Provider Demographics
NPI:1205632627
Name:BATISTA PEREZ, LISBET
Entity type:Individual
Prefix:
First Name:LISBET
Middle Name:
Last Name:BATISTA PEREZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3863 CORRIGAN CT
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33461-4005
Mailing Address - Country:US
Mailing Address - Phone:786-425-7465
Mailing Address - Fax:
Practice Address - Street 1:1601 BELVEDERE RD E-300
Practice Address - Street 2:SUITE 31
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-1554
Practice Address - Country:US
Practice Address - Phone:561-421-0047
Practice Address - Fax:561-421-0023
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-409094106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty