MEDICARE: CITY HEALTH PSC

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

General Provider Information

NPI Number	:	1508104407
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY HEALTH PSC

Provider Business Mailing Address
First Line	:	109 CALLE GUAYAMA
Second Line	:	HATO REY
City	:	SAN JUAN
State	:	PR
Zip	:	00917-4512
Country	:	US
Telephone Number	:	787-795-8855
Fax Number	:

Provider Business Practice Location Address
First Line	:	109 CALLE GUAYAMA
Second Line	:	HATO REY
City	:	SAN JUAN
State	:	PR
Zip	:	00917-4512
Country	:	US
Telephone Number	:	939-639-0584
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. GILDA PEREZ
Credential	:	M.D
Telephone Number	:	787-795-8855

Provider Enumeration Date	:	01/28/2013
Last Update Date	:	01/28/2013

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Directions to “CITY HEALTH PSC ” Practice Location

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