MEDICARE: DR. NELSON R VALERIO PEREZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	4002	PR

General Provider Information

NPI Number	:	1346451622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NELSON R VALERIO PEREZ MD

Provider Business Mailing Address
First Line	:	380 VIA VERSALLES
Second Line	:
City	:	GUAYNABO
State	:	PR
Zip	:	00969-5340
Country	:	US
Telephone Number	:	787-731-1127
Fax Number	:

Provider Business Practice Location Address
First Line	:	312 AVE DE DIEGO
Second Line	:	SUITE 504
City	:	SANTURCE
State	:	PR
Zip	:	00909-1756
Country	:	US
Telephone Number	:	787-641-4517
Fax Number	:	787-641-4518

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2007
Last Update Date	:	07/08/2007

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