Provider Demographics
NPI:1720880461
Name:PERAZA, LARIPZA
Entity type:Individual
Prefix:
First Name:LARIPZA
Middle Name:
Last Name:PERAZA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8247 NW 191ST LN
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-5308
Mailing Address - Country:US
Mailing Address - Phone:786-704-6818
Mailing Address - Fax:
Practice Address - Street 1:7900 NW 155TH ST STE 204
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-5844
Practice Address - Country:US
Practice Address - Phone:786-536-2037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBACB914539106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician