MEDICARE: DR. MILAGROS ENID PEREZ M.D.

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	208000000X	Pediatrics Physician	7371	PR

General Provider Information

NPI Number	:	1477539286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MILAGROS ENID PEREZ M.D.

Provider Business Mailing Address
First Line	:	PO BOX 7245
Second Line	:
City	:	PONCE
State	:	PR
Zip	:	00732-7245
Country	:	US
Telephone Number	:	787-844-5484
Fax Number	:	787-844-5484

Provider Business Practice Location Address
First Line	:	2404 CALLE NILO
Second Line	:	RIO CANAS
City	:	PONCE
State	:	PR
Zip	:	00728-1715
Country	:	US
Telephone Number	:	787-844-5484
Fax Number	:	787-844-5484

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

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	06/18/2014

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