Provider Demographics
NPI:1679321814
Name:IZQUIERDO PEREZ, NAYARA NANCY
Entity type:Individual
Prefix:
First Name:NAYARA
Middle Name:NANCY
Last Name:IZQUIERDO PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4656 SANTA BARBARA BLVD UNIT 1212
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34104-5515
Mailing Address - Country:US
Mailing Address - Phone:941-577-9010
Mailing Address - Fax:
Practice Address - Street 1:4656 SANTA BARBARA BLVD UNIT 1212
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104-5515
Practice Address - Country:US
Practice Address - Phone:941-577-9010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician