Provider Demographics
NPI:1285424903
Name:PEREZ GONZALEZ, YANELIS
Entity type:Individual
Prefix:
First Name:YANELIS
Middle Name:
Last Name:PEREZ GONZALEZ
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 1:4021 SAN MARINO BLVD APT 306
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-8624
Mailing Address - Country:US
Mailing Address - Phone:239-298-0804
Mailing Address - Fax:
Practice Address - Street 1:4021 SAN MARINO BLVD APT 306
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-8624
Practice Address - Country:US
Practice Address - Phone:239-298-0804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician