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General NPI Number Information
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NPI Number | 1306991641
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Entity Type | Individual
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Provider Name | NYDIA P. PEREZ O.D.
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Gender | Female
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 02/18/2012
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Provider Practice Location Address
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Address Line | LOS DOMINICOS SHOPPING CENTER SUITE 19
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City | LEVITTOWN
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State | PR
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Zip | 00949
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Country | US
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Telephone | 787-795-5109
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Fax | 787-795-5109
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Provider Business Mailing Address
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Address Line | CLEMSON ST. UNIVERSITY GARDENS 321B
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City | SAN JUAN
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State | PR
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Zip | 00927-4020
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Country | US
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Telephone | 787-448-0266
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Fax | 787-795-5109
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 344
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License Number State | PR
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