Healthcare Provider Details

I. General information

NPI: 1295191971
Provider Name (Legal Business Name): ROSA I PEREZ TORRES, MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2016
Last Update Date: 01/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 CALLE BASILIO CATALA 710 COND PRADOS DEL MONTE
GUAYNABO PR
00971-7601
US

IV. Provider business mailing address

29 CALLE BASILIO CATALA 710 COND PRADOS DEL MONTE
GUAYNABO PR
00971-7601
US

V. Phone/Fax

Practice location:
  • Phone: 787-292-9861
  • Fax: 787-292-9861
Mailing address:
  • Phone: 787-292-9861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number7663
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number7663
License Number StatePR

VIII. Authorized Official

Name: DR. ROSA I PEREZ TORRES
Title or Position: PEDITARICIAN
Credential: MD
Phone: 787-292-8615