Healthcare Provider Details

I. General information

NPI: 1184897100
Provider Name (Legal Business Name): MRS. MARILYN PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2008
Last Update Date: 04/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 2ND ST SW SUITE 5314
WASHINGTON DC
20593-0002
US

IV. Provider business mailing address

2100 2ND ST SW SUITE 5314
WASHINGTON DC
20593-0002
US

V. Phone/Fax

Practice location:
  • Phone: 787-890-8477
  • Fax: 787-890-8481
Mailing address:
  • Phone: 787-890-8477
  • Fax: 787-890-8481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: