Healthcare Provider Details

I. General information

NPI: 1295562478
Provider Name (Legal Business Name): SERVICIOS CLINICOS PEREZ CARDONA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2024
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CALLE CARAZO
GUAYNABO PR
00969-5717
US

IV. Provider business mailing address

PO BOX 3768
GUAYNABO PR
00970-3768
US

V. Phone/Fax

Practice location:
  • Phone: 787-720-2150
  • Fax:
Mailing address:
  • Phone: 787-720-2150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NESTOR PEREZ CARDONA
Title or Position: PRESIDENT
Credential: MD
Phone: 787-720-2150