Provider Demographics
NPI:1356952287
Name:PEREZ HERNANDEZ, CARINA
Entity type:Individual
Prefix:
First Name:CARINA
Middle Name:
Last Name:PEREZ HERNANDEZ
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 1:6416 SW 131ST PATH APT 1706
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-5626
Mailing Address - Country:US
Mailing Address - Phone:786-458-7205
Mailing Address - Fax:
Practice Address - Street 1:6416 SW 131ST PATH APT 1706
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-5626
Practice Address - Country:US
Practice Address - Phone:786-458-7205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-13
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-25-15937106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Single Specialty