MEDICARE: OLGA MICHELLE PEREIRA 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	207V00000X	Obstetrics & Gynecology Physician	20942	PR

General Provider Information

NPI Number	:	1518190230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLGA MICHELLE PEREIRA M.D.

Provider Business Mailing Address
First Line	:	300 AVE LA SIERRA APT 37
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00926-4337
Country	:	US
Telephone Number	:	787-667-9729
Fax Number	:

Provider Business Practice Location Address
First Line	:	1565 CALLE ALDA
Second Line	:	URB CARIBE
City	:	SAN JUAN
State	:	PR
Zip	:	00926
Country	:	US
Telephone Number	:	787-667-9729
Fax Number	:

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

Provider Enumeration Date	:	08/27/2009
Last Update Date	:	09/11/2019

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