Healthcare Provider Details
I. General information
NPI: 1518803519
Provider Name (Legal Business Name): ISABEL M. MAYORGA-PEREZ LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1451 AVE ASHFORD
SAN JUAN PR
00907-1511
US
IV. Provider business mailing address
206 CALLE ZORZAL
SAN JUAN PR
00926-7111
US
V. Phone/Fax
- Phone: 787-722-6544
- Fax:
- Phone: 787-722-6544
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ISABEL
M
MAYORGA-PEREZ
Title or Position: PRESIDENT
Credential:
Phone: 787-219-0199