Healthcare Provider Details

I. General information

NPI: 1437366903
Provider Name (Legal Business Name): JUAN J FUMERO-PEREZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 04/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 AVE. ORTEGON CAPARRA GALLERY, SUITE 208
GUAYNABO PR
00966-2519
US

IV. Provider business mailing address

107 AVE ORTEGON STE 208
GUAYNABO PR
00966-2518
US

V. Phone/Fax

Practice location:
  • Phone: 787-722-5006
  • Fax: 787-294-5250
Mailing address:
  • Phone: 787-722-5006
  • Fax: 787-294-5250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number9742
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: