Provider Demographics
NPI:1588383590
Name:PERROGON-CANEDO, MARIA ELIZABETH (RMHCI)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ELIZABETH
Last Name:PERROGON-CANEDO
Suffix:
Gender:F
Credentials:RMHCI
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:PERROGON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RMHCI
Mailing Address - Street 1:2371 SW 15TH ST APT 99
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-7540
Mailing Address - Country:US
Mailing Address - Phone:561-779-0748
Mailing Address - Fax:754-227-7804
Practice Address - Street 1:2371 SW 15TH ST APT 99
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-7540
Practice Address - Country:US
Practice Address - Phone:561-779-0748
Practice Address - Fax:754-227-7804
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH22830101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health