Individual provider Active NPI

Sandra I Perez, SOCIAL WORKER

  • Clinical Social Worker
  • Miami Lakes, FL
National Provider Identifier
1326630294
Registry record updated Feb 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PSW1091 Issued in FL
Practice address
14875 NW 77TH Avenue
Suite 201
Miami Lakes, FL 33014
Phone
(305) 351-7086
Fax
(350) 824-0665
NPI assigned
Feb 10, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X PSW1091 FL Primary

Addresses

Primary practice location

14875 NW 77TH Avenue
Suite 201
Miami Lakes, FL 33014

Mailing address

14875 NW 77TH Avenue
Suite 201
Miami Lakes, FL 33014
Phone (305) 351-7086

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSW1091FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Palliative Care Services, Inc. CurrentSince Aug 1, 2026 Accepting new patients
Sunshine Community & Behavior Services Corp CurrentSince Nov 13, 2022 Accepting new patients

Locations

33550 S Dixie Hwy
Ste 106
Homestead, FL 33034
Phone (305) 431-1376

14875 NW 77th Ave
Ste 201
Miami Lakes, FL 33014
Phone (305) 351-7086

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1326630294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14875 NW 77TH AVENUE",
            "address_2": "SUITE 201",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "33014",
            "telephone_number": "305-351-7086",
            "fax_number": "350-824-0665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14875 NW 77TH AVENUE",
            "address_2": "SUITE 201",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "33014",
            "telephone_number": "305-351-7086",
            "fax_number": "350-824-0665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "SANDRA",
        "middle_name": "I",
        "name_prefix": "Mrs.",
        "credential": "SOCIAL WORKER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-10",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "PSW1091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.