MEDICARE: ANGEL PEREZ M.D.

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	207RP1001X	Pulmonary Disease Physician	10890	PR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	600072	OTHER	PR	MEDICARE Y MUCHO MAS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	89031	OTHER	PR	TRIPLE S
2	2901307	OTHER	PR	ACAA
3	5028	OTHER	PR	PROSSAM
5	9590037	OTHER	PR	HUMANA INSURANCE
6	060452	OTHER	PR	CRUZ AZUL DE PR
7	1929	OTHER	PR	FIRST MEDICAL
8	218086	OTHER	PR	PREFERRED HEALTH

General Provider Information

NPI Number	:	1568408797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGEL PEREZ M.D.

Provider Business Mailing Address
First Line	:	PO BOX 422
Second Line	:
City	:	SABANA SECA
State	:	PR
Zip	:	00952-0422
Country	:	US
Telephone Number	:	787-884-6189
Fax Number	:

Provider Business Practice Location Address
First Line	:	EDIFICIO MEDICO PEDRO BLANCO LUGO
Second Line	:	TORRE MEDICA OFICINA 314 DR CENTER HOSPITAL
City	:	MANATI
State	:	PR
Zip	:	00674-0000
Country	:	US
Telephone Number	:	787-884-6189
Fax Number	:

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

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	07/09/2007

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