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1962805598 NPI number — LUIS G. PEREZ PEREZ M.D.

NPI Number: 1962805598
Health Care Provider/Practitioner: LUIS G. PEREZ PEREZ M.D.

Information about “1962805598” NPI (LUIS G. PEREZ PEREZ M.D.) exists in 1962805598 in HTML format HTML  |  1962805598 in plain Text format TXT  |  1962805598 in PDF (Portable Document Format) PDF  |  1962805598 in an XML format XML  formats.

NPI Number : 1962805598 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1962805598",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PEREZ PEREZ",
    "FirstName": "LUIS",
    "MiddleName": "G.",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "600 AVE JESUS T PINERO APT 2201",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SAN JUAN",
    "MailingAddressStateName": "PR",
    "MailingAddressPostalCode": "00918-4185",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "8 AVE LAS CUMBRES",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GUAYNABO",
    "PracticeLocationAddressStateName": "PR",
    "PracticeLocationAddressPostalCode": "00969-4818",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "787-740-8787",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/26/2014",
    "LastUpdateDate": "11/18/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "2085R0202X",
          "TaxonomyName": "Diagnostic Radiology Physician",
          "LicenseNumber": "21094",
          "LicenseNumberStateCode": "PR",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2085R0202X",
          "TaxonomyName": "Diagnostic Radiology Physician",
          "LicenseNumber": "31504",
          "LicenseNumberStateCode": "PR",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2085R0204X",
          "TaxonomyName": "Vascular & Interventional Radiology Physician",
          "LicenseNumber": "21094",
          "LicenseNumberStateCode": "PR",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
      }
    }
  }
}
                
            

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