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General NPI Number Information
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NPI Number | 1134598378
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Entity Type | Organization
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Legal Business Name | DR. OBED PEREZ GONZALEZ CSP
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Dates
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Enumeration Date | 09/17/2015
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Last Update Date | 09/17/2015
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Provider Practice Location Address
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Address Line | 100 AVE. HERNAN ALVAREZ PLAZA METROPOLITANA SUITE 207
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City | SAN GERMAN
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State | PR
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Zip | 00683
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Country | US
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Telephone | 787-892-0944
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Fax | 787-892-0944
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Provider Business Mailing Address
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Address Line | PO BOX 473
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City | SAN GERMAN
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State | PR
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Zip | 00683-0473
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Country | US
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Telephone | 787-892-0944
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Fax | 787-892-0944
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. OBED PEREZ GONZALEZ
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Credential | MD
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Telephone | 787-892-0944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 9517
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License Number State | PR
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