Healthcare Provider Details
I. General information
NPI: 1457452559
Provider Name (Legal Business Name): CESAR AUGUSTO PEREZ HERNANDEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
CARRETERA 30 INTERSECCION 921 BARRIO TEJAS
LAS PIEDRAS PR
00771
US
IV. Provider business mailing address
CARRETERA 30 INTERSECCION 921 BARRIO TEJAS
LAS PIEDRAS PR
00771
US
V. Phone/Fax
- Phone: 787-733-2347
- Fax:
- Phone: 787-733-2347
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2083P0901X |
| Taxonomy | Public Health & General Preventive Medicine Physician |
| License Number | 5619 |
| License Number State | PR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: