Provider Demographics
NPI:1609676162
Name:PEREZ TRIANA, DALMA
Entity type:Individual
Prefix:
First Name:DALMA
Middle Name:
Last Name:PEREZ TRIANA
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 1:18951 SW 311TH ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-3846
Mailing Address - Country:US
Mailing Address - Phone:305-766-0694
Mailing Address - Fax:
Practice Address - Street 1:18951 SW 311TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-3846
Practice Address - Country:US
Practice Address - Phone:305-766-0694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25-418300106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician