MEDICARE: MISS IVANYS PEREZ

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	103TS0200X	School Psychologist	3622	PR
2	103T00000X	Psychologist	3622	PR

General Provider Information

NPI Number	:	1891012985
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS IVANYS PEREZ

Provider Business Mailing Address
First Line	:	445 CALLE GAVIELA
Second Line	:
City	:	ARECIBO
State	:	PR
Zip	:	00612-5974
Country	:	US
Telephone Number	:	787-374-9005
Fax Number	:

Provider Business Practice Location Address
First Line	:	445 CALLE GAVIELA
Second Line	:
City	:	ARECIBO
State	:	PR
Zip	:	00612-5974
Country	:	US
Telephone Number	:	787-374-9005
Fax Number	:

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

Provider Enumeration Date	:	04/28/2010
Last Update Date	:	12/05/2025

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Directions to “ MISS IVANYS PEREZ ” Practice Location

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