Provider Demographics
NPI:1235977794
Name:DOCTOR PEREZ MEDICINA DE FAMILIA LLC
Entity type:Organization
Organization Name:DOCTOR PEREZ MEDICINA DE FAMILIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:PEREZ- LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-396-1162
Mailing Address - Street 1:REPARTO METROPOLITANO
Mailing Address - Street 2:CALLE 42 SE 1010
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921
Mailing Address - Country:US
Mailing Address - Phone:787-595-8337
Mailing Address - Fax:787-754-9501
Practice Address - Street 1:REPARTO METROPOLITANO
Practice Address - Street 2:CALLE 42 SE 1010
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-595-8337
Practice Address - Fax:787-754-9501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty