Provider Demographics
NPI:1245044338
Name:PEREZ VILLARREAL, DANIEL ALBERTO
Entity type:Individual
Prefix:
First Name:DANIEL ALBERTO
Middle Name:
Last Name:PEREZ VILLARREAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 NW 195TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-3274
Mailing Address - Country:US
Mailing Address - Phone:786-962-3270
Mailing Address - Fax:
Practice Address - Street 1:351 NW 195TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-3274
Practice Address - Country:US
Practice Address - Phone:786-962-3270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician