Provider Demographics
NPI:1114772100
Name:PEREZ BENITEZ, SAYRENIS A
Entity type:Individual
Prefix:
First Name:SAYRENIS
Middle Name:A
Last Name:PEREZ BENITEZ
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 1:4910 PINE RIDGE LN APT 5
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33417-5900
Mailing Address - Country:US
Mailing Address - Phone:786-739-0723
Mailing Address - Fax:
Practice Address - Street 1:4910 PINE RIDGE LN APT 5
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-5900
Practice Address - Country:US
Practice Address - Phone:786-739-0723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician