Individual
AILEN PEREZ HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5706 N HESPERIDES ST, TAMPA, FL 33614-5418
(813) 924-4609
Mailing address
7210 N MANHATTAN AVE APT 2521, TAMPA, FL 33614-3728
(813) 296-0899
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB1175466
FL
Other
Enumeration date
12/04/2024
Last updated
12/04/2024
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