Provider Demographics
NPI:1154179554
Name:PEREZ LOUZADO, ROSALIA
Entity type:Individual
Prefix:
First Name:ROSALIA
Middle Name:
Last Name:PEREZ LOUZADO
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 1:15437 SW 111TH LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-2733
Mailing Address - Country:US
Mailing Address - Phone:786-344-7645
Mailing Address - Fax:
Practice Address - Street 1:9100 SW 24TH ST STE 6
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-2067
Practice Address - Country:US
Practice Address - Phone:786-344-7645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician