MEDICARE: DR. SONIA ESTHER DIAZ 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	207V00000X	Obstetrics & Gynecology Physician	11810	PR

General Provider Information

NPI Number	:	1568463180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SONIA ESTHER DIAZ PEREZ M.D

Provider Business Mailing Address
First Line	:	735 AVE PONE DE LEON
Second Line	:	TORRE MEDICA AUXILIO MUTUO STE 511
City	:	SAN JUAN
State	:	PR
Zip	:	00917
Country	:	US
Telephone Number	:	787-763-5500
Fax Number	:	787-763-5621

Provider Business Practice Location Address
First Line	:	735 AVE PONCE DE LEON
Second Line	:	TORRE MEDICA AUXILUO MUTUO STE 511
City	:	SAN JUAN
State	:	PR
Zip	:	00917-5022
Country	:	US
Telephone Number	:	787-763-5500
Fax Number	:	787-763-5621

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

Provider Enumeration Date	:	08/04/2005
Last Update Date	:	10/19/2017

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