Provider Demographics
NPI:1952812000
Name:REAL, ALDEY PEREZ SR (HHA,RBT)
Entity Type:Individual
Prefix:MISS
First Name:ALDEY
Middle Name:PEREZ
Last Name:REAL
Suffix:SR
Gender:F
Credentials:HHA,RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3221 SW 142ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6728
Mailing Address - Country:US
Mailing Address - Phone:785-351-2015
Mailing Address - Fax:
Practice Address - Street 1:3221SW 142AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175
Practice Address - Country:US
Practice Address - Phone:786-351-2015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-17
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4094106S00000X
FL40-2017085106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician