Healthcare Provider Details

I. General information

NPI: 1215912308
Provider Name (Legal Business Name): ADRIAN PEREZ-COCHRAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 AVE. TITO CASTRO TORRE MEDICA SAN LUCAS SUITE 623
PONCE PUERTO RICO
00716
UM

IV. Provider business mailing address

PO BOX 7353
PONCE PR
00732-7353
US

V. Phone/Fax

Practice location:
  • Phone: 787-812-0909
  • Fax: 787-813-0566
Mailing address:
  • Phone: 787-812-0909
  • Fax: 787-812-0920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number11205
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: