Provider Demographics
NPI:1871340620
Name:PEREZ, MARY KARLA
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:KARLA
Last Name:PEREZ
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 1:7801 RAMONA ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-2457
Mailing Address - Country:US
Mailing Address - Phone:786-651-0238
Mailing Address - Fax:
Practice Address - Street 1:7801 RAMONA ST
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-2457
Practice Address - Country:US
Practice Address - Phone:786-651-0238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician