Individual
CARMEN PEREZ-ILLADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IMH
Contact information
Practice address
2802 ALOMA AVE, SUITE 102, WINTER PARK, FL 32792-3532
(407) 430-6300
(407) 628-3300
Mailing address
2802 ALOMA AVE, SUITE 102, WINTER PARK, FL 32792-3532
(407) 430-6300
(407) 628-3300
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH9110
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11758066
CAQH
FL
Enumeration date
03/22/2007
Last updated
07/17/2007
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