Provider Demographics
NPI:1194522813
Name:GOMEZ PEREZ, DANAYCE
Entity type:Individual
Prefix:
First Name:DANAYCE
Middle Name:
Last Name:GOMEZ PEREZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12950 SW 127TH AVE APT 208
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-7717
Mailing Address - Country:US
Mailing Address - Phone:786-846-1173
Mailing Address - Fax:
Practice Address - Street 1:12950 SW 127TH AVE APT 208
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-7717
Practice Address - Country:US
Practice Address - Phone:786-846-1173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-28
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-410505106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician