MEDICARE: DR. JUAN OVIDIO PEREZ-RODRIGUEZ 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	2080P0210X	Pediatric Nephrology Physician	6541	PR

General Provider Information

NPI Number	:	1831129279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUAN OVIDIO PEREZ-RODRIGUEZ MD

Provider Business Mailing Address
First Line	:	9 EMAJAGUA ST. COND. EMAJAGUA APT 5A
Second Line	:	PUNTA LAS MARIAS
City	:	SAN JUAN
State	:	PR
Zip	:	00913
Country	:	US
Telephone Number	:	787-754-4911
Fax Number	:

Provider Business Practice Location Address
First Line	:	PONCE DE LEON AVE. , AUXILIO MUTUO HOSPITAL
Second Line	:	TRANSPLANT OFFICE , 2ND. FLOOR
City	:	SAN JUAN
State	:	PR
Zip	:	00919-1227
Country	:	US
Telephone Number	:	787-754-4911
Fax Number	:

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

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	01/27/2011

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