Provider Demographics
NPI:1770356487
Name:PEREZ, ALESSANDRA MIA (PSYD)
Entity type:Individual
Prefix:
First Name:ALESSANDRA
Middle Name:MIA
Last Name:PEREZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 PONCE DE LEON BLVD STE 1120
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-3047
Mailing Address - Country:US
Mailing Address - Phone:787-422-2229
Mailing Address - Fax:
Practice Address - Street 1:999 PONCE DE LEON BLVD
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-3000
Practice Address - Country:US
Practice Address - Phone:305-605-5683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling