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General NPI Number Information
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NPI Number | 1578724605
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Entity Type | Organization
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Legal Business Name | OMAYPER
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Dates
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Enumeration Date | 06/20/2008
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Last Update Date | 06/20/2008
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Provider Practice Location Address
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Address Line | 112 ARZUAGA ST SUITE 605
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City | SAN JUAN
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State | PR
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Zip | 00925-3321
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Country | US
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Telephone | 787-547-3933
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Fax | 787-763-0200
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Provider Business Mailing Address
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Address Line | 112 CALLE ARZUAGA SUITE 605
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City | SAN JUAN
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State | PR
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Zip | 00925-3321
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Country | US
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Telephone | 787-547-3933
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Fax | 787-763-0200
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. OMAYRA PEREIRA ESTRADA
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Credential | MD
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Telephone | 787-547-3933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 651408
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License Number State | PR
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