Provider Demographics
NPI:1235951724
Name:PACHECO PEREZ, JOUNEX NICOLE
Entity type:Individual
Prefix:
First Name:JOUNEX
Middle Name:NICOLE
Last Name:PACHECO 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:PO BOX 320
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00951-0320
Mailing Address - Country:US
Mailing Address - Phone:787-525-5931
Mailing Address - Fax:
Practice Address - Street 1:1845 CARR 2 STE 403
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-7204
Practice Address - Country:US
Practice Address - Phone:787-602-1243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR001793363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical