Individual
ALICCET PEREZ GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2597 W 2ND AVE APT 3, HIALEAH, FL 33010-1532
(786) 418-0658
Mailing address
2597 W 2ND AVE APT 3, HIALEAH, FL 33010-1532
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-142050
FL
Other
Enumeration date
03/25/2021
Last updated
03/25/2021
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