Organization
MENTAL AUTONOMY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUIS RAFAEL PEROZO (OFFICER)
(954) 906-5947
Entity
Organization
Contact information
Practice address
5220 S UNIVERSITY DR STE 201C, DAVIE, FL 33328-5308
(954) 906-5947
(786) 329-6876
Mailing address
5220 S UNIVERSITY DR STE 201C, DAVIE, FL 33328-5308
(954) 906-5947
(786) 329-6876
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
10/19/2018
Last updated
01/29/2026
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