Individual provider Active NPI

Luisa Fernanda Perez

  • Behavior Analyst
  • Miami, FL
National Provider Identifier
1982204103
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-23-65159 Issued in FL
Practice address
13195 SW 134TH St Ste 201
Miami, FL 33186-4585
Phone
(786) 206-6500
NPI assigned
Oct 27, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X 1-23-65159 FL Primary

Addresses

Primary practice location

13195 SW 134TH St Ste 201
Miami, FL 33186-4585

Mailing address

11031 SW 25TH St Apt 1110
Miramar, FL 33025-7678
Phone (754) 260-7304

Other practice location 1

17773 SW 2nd St
Pembroke Pines, FL 33029-3924
Phone (954) 668-9859

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
Evolving Minds Together LLC CurrentSince May 29, 2022 Accepting new patients
Mod Behavior ABA, LLC Behavior Analyst Past Accepting new patients

Locations

17773 SW 2nd St
Pembroke Pines, FL 33029
Phone (954) 589-2347

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": "1603756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1982204103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11031 SW 25TH ST APT 1110",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330257678",
            "telephone_number": "754-260-7304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13195 SW 134TH ST STE 201",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331864585",
            "telephone_number": "786-206-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17773 SW 2nd St",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330293924",
            "country_code": "US",
            "telephone_number": "954-668-9859",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "LUISA",
        "middle_name": "FERNANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-27",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-23-65159",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 9, 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.

Verify at the official NPI Registry.