Individual provider Active NPI

Melanie Perez, PH.D.

  • Clinical Psychologist
  • Hollywood, FL
National Provider Identifier
1639233992
Registry record updated Oct 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
016701 Issued in NY
Practice address
950 Hillcrest Dr
Apt 408
Hollywood, FL 33021-7857
Phone
(917) 309-6783
Fax
(718) 238-3001
NPI assigned
Dec 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 016701 NY Primary
Clinical Psychologist 103TC0700X PY8148 FL

Addresses

Primary practice location

950 Hillcrest Dr
Apt 408
Hollywood, FL 33021-7857

Mailing address

950 Hillcrest Dr
Apt 408
Hollywood, FL 33021-7857
Phone (917) 309-6783

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110204000819 FL Practitioner - Clinical Psychologist 1658439328 Practice locations: Lakeland, FL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY8148FLMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285891200000",
    "number": "1639233992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 HILLCREST DR",
            "address_2": "APT 408",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330217857",
            "telephone_number": "917-309-6783",
            "fax_number": "718-238-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 HILLCREST DR",
            "address_2": "APT 408",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330217857",
            "telephone_number": "917-309-6783",
            "fax_number": "718-238-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "MELANIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2010-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "016701",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY8148",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.