Provider Demographics
NPI:1548134802
Name:BRUNO PEREZ, LEVID ANTHONY (MS)
Entity type:Individual
Prefix:
First Name:LEVID
Middle Name:ANTHONY
Last Name:BRUNO PEREZ
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 CALLE ROBLE
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-8311
Mailing Address - Country:US
Mailing Address - Phone:787-773-1816
Mailing Address - Fax:
Practice Address - Street 1:90 CALLE ALONDRA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924-3256
Practice Address - Country:US
Practice Address - Phone:787-773-1816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-30
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8351103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling