Healthcare Provider Details

I. General information

NPI: 1508692575
Provider Name (Legal Business Name): FERNANDEZPEREZ MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2024
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

B1 CALLE SANTA CRUZ CARIMED PLAZA 403
BAYAMON PR
00961-6928
US

IV. Provider business mailing address

B1 CALLE SANTA CRUZ CARIMED PLAZA 403
BAYAMON PR
00961-6928
US

V. Phone/Fax

Practice location:
  • Phone: 787-798-7070
  • Fax:
Mailing address:
  • Phone: 787-798-7070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: SAMUEL FERNANDEZ PEREZ
Title or Position: CEO
Credential: MD
Phone: 787-798-7070