Active NPI
Rudy Hernandez Perez, LCSW-I, CBHCMS,CMHP
- Clinical Social Worker
- Miami, FL
National Provider Identifier
1134831191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- ISW18375
- Practice address
- 2720 SW 97TH Ave Ste C-105
Miami, FL 33165-2677 - Phone
- (786) 332-4330
- NPI assigned
- Dec 21, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | ISW18375 | FL | Primary |
| Mental Health Counselor | 101YM0800X | ISW18375 | FL |
Addresses
Primary practice location
2720 SW 97TH Ave Ste C-105
Miami, FL 33165-2677
Mailing address
10425 SW 112TH Ave Apt 115
Miami, FL 33176-8207
Other practice location 1
654 NE 9th Pl
Homestead, FL 33030-4934
Phone (305) 248-3488
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CBHCMS0102594 | Other | FL | FLORIDA CERTIFICATION BOARD |
| ISW18375 | Other | FL | FLORIDA HEALTH DEPARTMENT |
| CBHCM0103610 | Other | FL | FLORIDA CERTIFICATION BOARD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ISW18375 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1671580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682035200000",
"number": "1134831191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10425 SW 112TH AVE APT 115",
"city": "MIAMI",
"state": "FL",
"postal_code": "331768207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2720 SW 97TH AVE STE C-105",
"city": "MIAMI",
"state": "FL",
"postal_code": "331652677",
"telephone_number": "786-332-4330"
}
],
"practiceLocations": [
{
"address_1": "654 NE 9th Pl",
"address_purpose": "LOCATION",
"city": "Homestead",
"state": "FL",
"postal_code": "330304934",
"country_code": "US",
"telephone_number": "305-248-3488",
"fax_number": "305-248-6558",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HERNANDEZ PEREZ",
"first_name": "RUDY",
"name_prefix": "Mr.",
"credential": "LCSW-I, CBHCMS,CMHP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-12-21",
"last_updated": "2023-04-21",
"certification_date": "2023-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "ISW18375",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "ISW18375",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLORIDA CERTIFICATION BOARD",
"identifier": "CBHCMS0102594",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLORIDA HEALTH DEPARTMENT",
"identifier": "ISW18375",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLORIDA CERTIFICATION BOARD",
"identifier": "CBHCM0103610",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.