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General NPI Number Information
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NPI Number | 1710100623
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Entity Type | Organization
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Legal Business Name | PEREZ Y SANTOS RENAL MEDICAL
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 03/25/2014
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Provider Practice Location Address
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Address Line | 3011 AVE FAGOT
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City | PONCE
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State | PR
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Zip | 00716-3637
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Country | US
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Telephone | 787-841-8201
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 331990
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City | PONCE
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State | PR
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Zip | 00733-1990
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Country | US
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Telephone | 787-841-8201
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. DANIEL PEREZ
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Credential | M.D.
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Telephone | 787-841-8201
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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 |
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License Number State |
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