Provider Demographics
NPI:1457101933
Name:SALLENT PEREZ, JAIME (RBT)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:SALLENT PEREZ
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12040 CORINTHIAN ST
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-5678
Mailing Address - Country:US
Mailing Address - Phone:727-267-2666
Mailing Address - Fax:
Practice Address - Street 1:12040 CORINTHIAN ST
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-5678
Practice Address - Country:US
Practice Address - Phone:727-267-2666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-331199106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician