Healthcare Provider Details

I. General information

NPI: 1356265029
Provider Name (Legal Business Name): NEISHMARIE PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 446 BO LLANADAS ISABELA
ISABELA PR
00662
US

IV. Provider business mailing address

8055 CALLE GUTIERREZ PEREZ
ISABELA PR
00662-6430
US

V. Phone/Fax

Practice location:
  • Phone: 787-980-9751
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number9138
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: