Individual
FREDLYNN J PERICLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4008 SW 23RD ST, WEST PARK, FL 33023-3437
(786) 230-7779
Mailing address
20110 NE 3RD CT, MIAMI, FL 33179-2962
(786) 230-7779
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
251E00000X
Home Health Agency
Primary
—
FL
310400000X
Assisted Living Facility
—
—
Other
Enumeration date
02/26/2018
Last updated
08/12/2025
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