Healthcare Provider Details

I. General information

NPI: 1235951724
Provider Name (Legal Business Name): JOUNEX NICOLE PACHECO PEREZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2024
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1845 CARR 2 STE 403
BAYAMON PR
00959-7204
US

IV. Provider business mailing address

PO BOX 320
TOA BAJA PR
00951-0320
US

V. Phone/Fax

Practice location:
  • Phone: 787-602-1243
  • Fax:
Mailing address:
  • Phone: 787-525-5931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number25107
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: