Provider Demographics
NPI:1205657772
Name:SANCHEZ PEREZ, LAUREN LILIAN
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:LILIAN
Last Name:SANCHEZ PEREZ
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 1:7617 SOUTHERN BROOK BND APT 301
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33635-1858
Mailing Address - Country:US
Mailing Address - Phone:786-237-7584
Mailing Address - Fax:
Practice Address - Street 1:7617 SOUTHERN BROOK BND APT 301
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33635-1858
Practice Address - Country:US
Practice Address - Phone:786-237-7584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-348455106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician