Provider Demographics
NPI:1437044476
Name:PEREZ, EDUARDO SEBASTIAN
Entity type:Individual
Prefix:
First Name:EDUARDO
Middle Name:SEBASTIAN
Last Name:PEREZ
Suffix:
Gender:M
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 8901 PMB 235
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-9141
Mailing Address - Country:US
Mailing Address - Phone:939-273-4228
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 8901 PMB 235
Practice Address - Street 2:
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659-9141
Practice Address - Country:US
Practice Address - Phone:939-273-4228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6976448390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program