Healthcare Provider Details
I. General information
NPI: 1912937228
Provider Name (Legal Business Name): SARA E PEREZ-TORRES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/03/2006
Last Update Date: 09/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1970 ROANOKE BLVD
SALEM VA
24153-6404
US
IV. Provider business mailing address
1970 ROANOKE BLVD WOMEN'S HEALTH CLINIC BLD#5
SALEM VA
24153-6404
US
V. Phone/Fax
- Phone: 540-982-2463
- Fax: 540-224-1945
- Phone: 540-982-2463
- Fax: 540-224-1945
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | 49118 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: