Healthcare Provider Details

I. General information

NPI: 1659527265
Provider Name (Legal Business Name): IRMA E. PEREZ-AMARO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2008
Last Update Date: 08/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 CALLE ROSALES VILLAS DEL CAPITAN
ARECIBO PR
00612-3372
US

IV. Provider business mailing address

14 CALLE ROSALES VILLAS DEL CAPITAN
ARECIBO PR
00612-3372
US

V. Phone/Fax

Practice location:
  • Phone: 787-390-5214
  • Fax:
Mailing address:
  • Phone: 787-390-5214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number26608R
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: