Provider Demographics
NPI:1407680283
Name:PEREZ, RAYF SR
Entity type:Individual
Prefix:
First Name:RAYF
Middle Name:
Last Name:PEREZ
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:RAYF
Other - Middle Name:PEREZ
Other - Last Name:SOBRINO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4605 SW 165TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-5199
Mailing Address - Country:US
Mailing Address - Phone:786-690-4785
Mailing Address - Fax:
Practice Address - Street 1:4605 SW 167TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185
Practice Address - Country:US
Practice Address - Phone:786-690-4785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA105379225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist