Provider Demographics
NPI:1174924336
Name:PEREZ, MARIA JULIA (, MA, BCBA)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:JULIA
Last Name:PEREZ
Suffix:
Gender:F
Credentials:, MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11540 SW 107TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-4079
Mailing Address - Country:US
Mailing Address - Phone:305-343-5234
Mailing Address - Fax:
Practice Address - Street 1:11755 SW 90TH ST
Practice Address - Street 2:SUITE 210
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-2177
Practice Address - Country:US
Practice Address - Phone:305-846-9807
Practice Address - Fax:305-846-9711
Is Sole Proprietor?:No
Enumeration Date:2014-09-08
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X, 106E00000X
FL12475726103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst