Provider Demographics
NPI:1750117958
Name:PEREZ TORRES, XAYMARA
Entity type:Individual
Prefix:
First Name:XAYMARA
Middle Name:
Last Name:PEREZ TORRES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5721 SUNBONNET WAY FL 34771
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34771-8487
Mailing Address - Country:US
Mailing Address - Phone:407-230-5967
Mailing Address - Fax:
Practice Address - Street 1:5721 SUNBONNET WAY FL 34771
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34771-8487
Practice Address - Country:US
Practice Address - Phone:407-230-5967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-12
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist