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General NPI Number Information
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NPI Number | 1326103292
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Entity Type | Individual
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Provider Name | JESUS ANTONIO PEREZ RODRIGUEZ MD
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Gender | Male
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 49 CALLE BARCELO
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City | VILLALBA
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State | PR
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Zip | 00766-2205
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Country | US
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Telephone | 787-847-0457
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Fax | 787-847-0457
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Provider Business Mailing Address
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Address Line | 609 AVE TITO CASTRO SUITE 102 PMB 451
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City | PONCE
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State | PR
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Zip | 00716-0200
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Country | US
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Telephone | 787-837-4122
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Fax | 787-837-4122
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 10874
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License Number State | PR
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