Individual provider Active NPI

Freddy F Perez

  • Assistant Behavior Analyst
  • Coral Gables, FL
National Provider Identifier
1518639194
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
Practice address
717 Ponce de Leon Blvd Ste 323a
Coral Gables, FL 33134-2050
Phone
(786) 580-1165
NPI assigned
Oct 1, 2021
Last updated
Aug 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X Primary

Addresses

Primary practice location

717 Ponce de Leon Blvd Ste 323a
Coral Gables, FL 33134-2050

Mailing address

717 Ponce de Leon Blvd Ste 323a
Coral Gables, FL 33134-2050
Phone (786) 580-1165

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wingless Angels Behavioral Services, LLC. CurrentSince Sep 1, 2024 Accepting new patients

Locations

717 Ponce de Leon Blvd
Ste 323A
Coral Gables, FL 33134
Phone (786) 580-1165

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1633046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1518639194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 PONCE DE LEON BLVD STE 323A",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331342050",
            "telephone_number": "786-580-1165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 PONCE DE LEON BLVD STE 323A",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331342050",
            "telephone_number": "786-580-1165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "FREDDY",
        "middle_name": "F",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-01",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; 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.