Healthcare Provider Details

I. General information

NPI: 1356379531
Provider Name (Legal Business Name): MARCOS PEREZ-BRAYFIELD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 09/23/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

258 CALLE SAN JORGE
SAN JUAN PR
00912
US

IV. Provider business mailing address

PO BOX 270181
SAN JUAN PR
00928-2981
US

V. Phone/Fax

Practice location:
  • Phone: 787-301-0489
  • Fax:
Mailing address:
  • Phone: 787-301-0489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2088P0231X
TaxonomyPediatric Urology Physician
License Number16754
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number88970
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number16754
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: