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General NPI Number Information
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NPI Number | 1831757350
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Entity Type | Individual
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Provider Name | JUAN CRISTIAN PEREZ OLMOS MD
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Gender | Male
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Dates
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Enumeration Date | 05/30/2019
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 4641 FAIRFIELD ST STE F
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City | METAIRIE
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State | LA
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Zip | 70006-2763
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Country | US
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Telephone | 504-988-7250
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 600
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City | MAYAGUEZ
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State | PR
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Zip | 00681-0600
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Country | US
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Telephone | 787-652-9200
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Fax | 787-652-1662
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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 | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number | 342972
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number | 22074
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License Number State | PR
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