Provider Demographics
NPI:1366808040
Name:PERALTA, ADRIANA (MSW)
Entity type:Individual
Prefix:MS
First Name:ADRIANA
Middle Name:
Last Name:PERALTA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12827 SW 29TH ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-4113
Mailing Address - Country:US
Mailing Address - Phone:954-557-1878
Mailing Address - Fax:
Practice Address - Street 1:1000 N HIATUS RD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-3097
Practice Address - Country:US
Practice Address - Phone:954-333-8787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-11
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical