Healthcare Provider Details

I. General information

NPI: 1740415041
Provider Name (Legal Business Name): LILIANA MORALES PEREZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2009
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 191079
SAN JUAN PR
00919-1079
US

IV. Provider business mailing address

PO BOX 191079
SAN JUAN PR
00919-1079
US

V. Phone/Fax

Practice location:
  • Phone: 787-474-0333
  • Fax:
Mailing address:
  • Phone: 787-474-0333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number18394
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberQ1683
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number18394
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: