Healthcare Provider Details

I. General information

NPI: 1003036393
Provider Name (Legal Business Name): ORLANDO PEREZ PEREZ RN,BSN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2007
Last Update Date: 10/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ANTIGUO HOSPITAL DE DISTRITO STREET #129
ARECIBO PR
00612
US

IV. Provider business mailing address

HC 1 BOX 5038 BARRIO CIBAO
CAMUY PR
00627-9159
US

V. Phone/Fax

Practice location:
  • Phone: 787-878-3552
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number20764
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: