Provider Demographics
NPI:1740516657
Name:PEREZ, JANELY (PTA)
Entity type:Individual
Prefix:MISS
First Name:JANELY
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MRS
Other - First Name:JANELY
Other - Middle Name:
Other - Last Name:MANESIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PTA
Mailing Address - Street 1:1500 S DOUGLAS RD
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-4108
Mailing Address - Country:US
Mailing Address - Phone:305-448-0146
Mailing Address - Fax:
Practice Address - Street 1:1500 S DOUGLAS RD
Practice Address - Street 2:#210
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-4108
Practice Address - Country:US
Practice Address - Phone:305-448-0146
Practice Address - Fax:305-448-0147
Is Sole Proprietor?:No
Enumeration Date:2009-10-28
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA20142225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant