MEDICARE: DR. CIELOMAR PEREZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	6657	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6657	OTHER	PR	LICENCIA

General Provider Information

NPI Number	:	1093792178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CIELOMAR PEREZ MD

Provider Business Mailing Address
First Line	:	1626 CALLE TIGRIS
Second Line	:	RIO PIEDRAS HEIGHTS
City	:	SAN JUAN
State	:	PR
Zip	:	00926-2942
Country	:	US
Telephone Number	:	787-754-1249
Fax Number	:	787-733-4235

Provider Business Practice Location Address
First Line	:	1626 CALLE TIGRIS
Second Line	:	RIO PIEDRAS HEIGHTS
City	:	SAN JUAN
State	:	PR
Zip	:	00926-2942
Country	:	US
Telephone Number	:	787-717-1466
Fax Number	:	787-733-4235

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2005
Last Update Date	:	04/04/2024

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