Provider Demographics
NPI:1972556124
Name:PEREZ VERDECIA, FRANK ROBERTO (PSYD, LMHC, BCBA)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:ROBERTO
Last Name:PEREZ VERDECIA
Suffix:
Gender:M
Credentials:PSYD, LMHC, BCBA
Other - Prefix:DR
Other - First Name:FRANK
Other - Middle Name:R
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:2020 PONCE DE LEON BLVD STE 1201
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-4476
Mailing Address - Country:US
Mailing Address - Phone:305-917-5414
Mailing Address - Fax:305-220-1864
Practice Address - Street 1:2020 PONCE DE LEON BLVD STE 1201
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-4476
Practice Address - Country:US
Practice Address - Phone:305-917-5414
Practice Address - Fax:305-220-1864
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10722101YM0800X
FLPY8713103G00000X, 103TF0000X, 103TM1800X, 103TR0400X, 103TC2200X
FLPY7813103K00000X
FLBCBA11830222103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL688875598Medicaid
FL017755200Medicaid
FL017772200Medicaid
FL688875596Medicaid