Individual
SUSANA PEREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CBHCM-P
Contact information
Practice address
191 NW 97TH AVE APT 114, MIAMI, FL 33172-4116
(786) 372-2133
Mailing address
191 NW 97TH AVE APT 114, MIAMI, FL 33172-4116
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CBHCM-P102505
FL
251B00000X
Case Management Agency
CBHCM-P102505
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P625-780-85-669-0
CREDENTIAL NUMBER
FL
Enumeration date
01/27/2022
Last updated
01/27/2022
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