Individual
DR. MARISA JUDITH PERERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3081 SALZEDO ST STE 202, CORAL GABLES, FL 33134-6725
(305) 204-8292
Mailing address
7901 4TH ST N STE 300, ST PETERSBURG, FL 33702-4399
(305) 204-8292
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
11293
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11293
FLORIDA PSYCHOLOGY LICENSE
FL
Enumeration date
05/19/2022
Last updated
01/25/2023
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