Provider Demographics
NPI:1366233223
Name:PEREZ RODRIGUEZ, LAIN
Entity type:Individual
Prefix:DR
First Name:LAIN
Middle Name:
Last Name:PEREZ RODRIGUEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9958 N KENDALL DR APT 527
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1752
Mailing Address - Country:US
Mailing Address - Phone:786-794-4123
Mailing Address - Fax:
Practice Address - Street 1:9958 N KENDALL DR APT 527
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1752
Practice Address - Country:US
Practice Address - Phone:786-794-4123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25430442106S00000X
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician