Provider Demographics
NPI:1427863190
Name:PERRERZ HERNANDEZ, LIANELYS E
Entity type:Individual
Prefix:
First Name:LIANELYS
Middle Name:E
Last Name:PERRERZ HERNANDEZ
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 1:14801 FILLMORE ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-7613
Mailing Address - Country:US
Mailing Address - Phone:305-744-6671
Mailing Address - Fax:
Practice Address - Street 1:14801 FILLMORE ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-7613
Practice Address - Country:US
Practice Address - Phone:305-744-6671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-410661106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty