Healthcare Provider Details

I. General information

NPI: 1497951669
Provider Name (Legal Business Name): ROSA IVETTE PEREZ-TORRES MD, MPH, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 CALLE BASILIO CATALA # 710
GUAYNABO PR
00971-7604
US

IV. Provider business mailing address

PO BOX 10241
SAN JUAN PR
00922-0241
US

V. Phone/Fax

Practice location:
  • Phone: 787-292-8615
  • Fax:
Mailing address:
  • Phone: --
  • Fax: --

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number7663
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: