Provider Demographics
NPI:1124322011
Name:PEREZ-DELGADO, JULIO C (LMHC)
Entity type:Individual
Prefix:
First Name:JULIO
Middle Name:C
Last Name:PEREZ-DELGADO
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 BRICKELL KEY DR APT 406
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-2604
Mailing Address - Country:US
Mailing Address - Phone:786-592-2323
Mailing Address - Fax:305-713-1207
Practice Address - Street 1:13595 SW 134TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4579
Practice Address - Country:US
Practice Address - Phone:786-592-2323
Practice Address - Fax:305-713-1207
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-06
Last Update Date:2019-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X, 103K00000X
FLMH12050101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty