Provider Demographics
NPI:1699102855
Name:PERERA-DUARTE, AIMEE LYNN (PSYD)
Entity type:Individual
Prefix:DR
First Name:AIMEE
Middle Name:LYNN
Last Name:PERERA-DUARTE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12001 SW 128TH CT STE 111
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-4664
Mailing Address - Country:US
Mailing Address - Phone:305-519-5409
Mailing Address - Fax:
Practice Address - Street 1:12001 SW 128TH CT STE 111
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4664
Practice Address - Country:US
Practice Address - Phone:305-519-5409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7326103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist