Provider Demographics
NPI:1881284420
Name:PEREZ, AIMEE YOLANDA (MENTAL HEALTH)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:YOLANDA
Last Name:PEREZ
Suffix:
Gender:F
Credentials:MENTAL HEALTH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1865 BRICKELL AVE APT A403
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-1627
Mailing Address - Country:US
Mailing Address - Phone:305-333-5319
Mailing Address - Fax:
Practice Address - Street 1:1865 BRICKELL AVE APT A403
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33129-1627
Practice Address - Country:US
Practice Address - Phone:305-333-5319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-18
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH15269101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL023205100Medicaid