Healthcare Provider Details

I. General information

NPI: 1225166457
Provider Name (Legal Business Name): ZAIDA PEREZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 AVE A COND VISTA REAL BUZON 36
FAJARDO PR
00738
US

IV. Provider business mailing address

400 AVE A COND VISTA REAL BUZON 36
FAJARDO PR
00738
US

V. Phone/Fax

Practice location:
  • Phone: 787-801-0081
  • Fax: 787-801-0086
Mailing address:
  • Phone: 787-801-0081
  • Fax: 787-801-0086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number6343
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: