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General NPI Number Information
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NPI Number | 1548134802
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Entity Type | Individual
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Provider Name | LEVID ANTHONY BRUNO PEREZ MS
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Gender | Male
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Dates
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Enumeration Date | 09/30/2025
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 90 CALLE ALONDRA
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City | SAN JUAN
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State | PR
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Zip | 00924-3256
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Country | US
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Telephone | 787-773-1816
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Fax |
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Provider Business Mailing Address
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Address Line | 164 CALLE ROBLE
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City | CAROLINA
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State | PR
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Zip | 00987-8311
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Country | US
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Telephone | 787-773-1816
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Fax |
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 8351
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License Number State | PR
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