Provider Demographics
NPI:1447929385
Name:PEREZ GARCIA, FELIX SAMUEL (RBT)
Entity type:Individual
Prefix:
First Name:FELIX
Middle Name:SAMUEL
Last Name:PEREZ GARCIA
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 NW 109TH AVE APT 104
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-5254
Mailing Address - Country:US
Mailing Address - Phone:786-803-2732
Mailing Address - Fax:
Practice Address - Street 1:230 NW 109TH AVE APT 104
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-5254
Practice Address - Country:US
Practice Address - Phone:786-803-2732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-21-167556106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL110856000Medicaid