Healthcare Provider Details

I. General information

NPI: 1750780466
Provider Name (Legal Business Name): CANCER CENTER OF THE CARIBBEAN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2014
Last Update Date: 08/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 PONCE DE LEON EDIF MIDTOWN SUITE 805
SAN JUAN PR
00919-0000
US

IV. Provider business mailing address

PO BOX 8520
SAN JUAN PR
00910-0520
US

V. Phone/Fax

Practice location:
  • Phone: 787-919-7690
  • Fax: 787-919-7694
Mailing address:
  • Phone: 787-562-5168
  • Fax: 787-722-9030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARIA ELOISA PEREZ
Title or Position: PRESIDENT
Credential: M.D.
Phone: 787-934-1838