Individual
DEISY MEDEROS PERDOMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5051 MEMORIAL HWY UNIT B, TAMPA, FL 33634-7355
(813) 290-0779
(305) 675-2216
Mailing address
9305 N 20TH ST, TAMPA, FL 33612-8623
(786) 601-7217
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
BCABA-0-24-15409
FL
106S00000X
Behavior Technician
RBT-19-80773
FL
Other
Enumeration date
04/10/2019
Last updated
03/17/2026
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