Provider Demographics
NPI:1558031997
Name:PEREZ MOTA, TALIA
Entity type:Individual
Prefix:
First Name:TALIA
Middle Name:
Last Name:PEREZ MOTA
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 1:7721 NW 7TH ST APT 502
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-6118
Mailing Address - Country:US
Mailing Address - Phone:305-431-5902
Mailing Address - Fax:
Practice Address - Street 1:1250 SW 27TH AVE STE 402
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-4750
Practice Address - Country:US
Practice Address - Phone:305-619-9231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-16
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty