MEDICARE: DR. MANUEL J. PEREZ PABON 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	207R00000X	Internal Medicine Physician	6963	PR

General Provider Information

NPI Number	:	1952509614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MANUEL J. PEREZ PABON M.D.

Provider Business Mailing Address
First Line	:	1051 CALLE 3 SE
Second Line	:	508
City	:	RIO PIEDRAS
State	:	PR
Zip	:	00921-3017
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1051 CALLE 3 SE
Second Line	:	508
City	:	RIO PIEDRAS
State	:	PR
Zip	:	00921-3000
Country	:	US
Telephone Number	:	787-313-6871
Fax Number	:

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

Provider Enumeration Date	:	07/04/2007
Last Update Date	:	07/09/2007

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