Provider Demographics
NPI:1437968336
Name:PEREZ VALLADARES, DANAY ISMARAY
Entity type:Individual
Prefix:
First Name:DANAY
Middle Name:ISMARAY
Last Name:PEREZ VALLADARES
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 1:9045 DALE DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-1988
Mailing Address - Country:US
Mailing Address - Phone:813-503-0194
Mailing Address - Fax:
Practice Address - Street 1:9045 DALE DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-1988
Practice Address - Country:US
Practice Address - Phone:813-503-0194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-402693106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician