=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558309302
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RAMON PEREZ MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/03/2006
-----------------------------------------------------
Last Update Date | 08/16/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | ST 171 KM 0 HM 4 BO. SUD
-----------------------------------------------------
City | CIDRA
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00739
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-739-8484
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 9968
-----------------------------------------------------
City | CIDRA
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00739-8968
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-586-0650
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 13645
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------