Healthcare Provider Details

I. General information

NPI: 1356351407
Provider Name (Legal Business Name): JOSE M PEREZ GARCIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 04/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CALLE GEORGETTI
BARCELONETA PR
00617-2714
US

IV. Provider business mailing address

P.O. BOX 140461
ARECIBO PR
00614
US

V. Phone/Fax

Practice location:
  • Phone: 787-970-0707
  • Fax:
Mailing address:
  • Phone: 787-970-0707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number11693
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier02498
Identifier TypeOTHER
Identifier StatePR
Identifier IssuerAMERICAN HEALTH
# 2
Identifier060156
Identifier TypeOTHER
Identifier StatePR
Identifier IssuerCRUZ AZUL
# 3
Identifier3033-5-5025
Identifier TypeOTHER
Identifier StatePR
Identifier IssuerASOCIACION MAESTROS
# 4
Identifier212604
Identifier TypeOTHER
Identifier StatePR
Identifier IssuerPREFERRED HEALTH
# 5
Identifier6170027
Identifier TypeOTHER
Identifier StatePR
Identifier IssuerHUMANA
# 6
Identifier8736
Identifier TypeOTHER
Identifier StatePR
Identifier IssuerINTERNATIONAL MEDICAL
# 7
Identifier211693
Identifier TypeOTHER
Identifier StatePR
Identifier IssuerCIGNA
# 8
Identifier100079
Identifier TypeOTHER
Identifier StatePR
Identifier IssuerMMM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: