Provider Demographics
NPI:1699593145
Name:PEREZ RODRIGUEZ, SUZEL TERESITA
Entity type:Individual
Prefix:
First Name:SUZEL
Middle Name:TERESITA
Last Name:PEREZ RODRIGUEZ
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 1:4371 NW 195TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-2132
Mailing Address - Country:US
Mailing Address - Phone:786-851-9922
Mailing Address - Fax:
Practice Address - Street 1:4371 NW 195TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33055-2132
Practice Address - Country:US
Practice Address - Phone:786-851-9922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician