Provider Demographics
NPI:1427731876
Name:PEREZ, LISBEYS
Entity type:Individual
Prefix:
First Name:LISBEYS
Middle Name:
Last Name:PEREZ
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 1:14901 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-7664
Mailing Address - Country:US
Mailing Address - Phone:786-740-6059
Mailing Address - Fax:786-522-7204
Practice Address - Street 1:14901 HARRISON ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-7664
Practice Address - Country:US
Practice Address - Phone:786-740-6059
Practice Address - Fax:786-522-7204
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-11
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-272917106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician