Provider Demographics
NPI:1427879741
Name:PEREZ, YERSON MIGUEL
Entity type:Individual
Prefix:MR
First Name:YERSON
Middle Name:MIGUEL
Last Name:PEREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 LANTANA RD APT 3404
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33462-0927
Mailing Address - Country:US
Mailing Address - Phone:786-633-7215
Mailing Address - Fax:
Practice Address - Street 1:2350 LANTANA RD APT 3404
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33462-0927
Practice Address - Country:US
Practice Address - Phone:786-633-7215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-19
Last Update Date:2024-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician