Healthcare Provider Details

I. General information

NPI: 1992118806
Provider Name (Legal Business Name): LUIS PEREZ-ABREU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2014
Last Update Date: 02/09/2024
Certification Date: 02/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB EL MIRADOR B1, CALLE 3
SAN JUAN PR
00926-0092
US

IV. Provider business mailing address

URB EL MIRADOR B1, CALLE 3
SAN JUAN PR
00926-1267
US

V. Phone/Fax

Practice location:
  • Phone: 787-602-0361
  • Fax:
Mailing address:
  • Phone: 787-602-0361
  • Fax: 614-293-6935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number35.127269
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME138621
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number21638
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: