Healthcare Provider Details

I. General information

NPI: 1689437808
Provider Name (Legal Business Name): ERIC JOSE PEREZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2024
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UPR RECINTO DE CIENCIAS MEDICAS AREA CENTRO MEDICO RIO PIEDRAS, PUERTO RICO
SAN JUAN PR
00936-5067
US

IV. Provider business mailing address

PO BOX 70
SAN ANTONIO PR
00690-0070
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-2525
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number17989-I
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: