Provider Demographics
NPI:1861413908
Name:PEREZ, JANELLE KAMERMAN (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JANELLE
Middle Name:KAMERMAN
Last Name:PEREZ
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6001 COUNTRY WALK LN
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-1932
Mailing Address - Country:US
Mailing Address - Phone:863-292-0762
Mailing Address - Fax:863-292-0762
Practice Address - Street 1:6001 COUNTRY WALK LN
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-1932
Practice Address - Country:US
Practice Address - Phone:863-292-0762
Practice Address - Fax:863-292-0762
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA8059235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist