Healthcare Provider Details

I. General information

NPI: 1932939121
Provider Name (Legal Business Name): JOEL PEREZ CARRERO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2024
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE ALEGRIA 48 URB. MANUEL CORCHADO
ISABELA PR
00662
US

IV. Provider business mailing address

48 CALLE ALEGRIA URB MANUEL CORCHADO
ISABELA PR
00662-2789
US

V. Phone/Fax

Practice location:
  • Phone: 787-948-5635
  • Fax:
Mailing address:
  • Phone: 787-948-5635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number543
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number16876I
License Number StatePR
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number24212
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: