Doctor Name: | DR. ELBA ANTOINETTE PEREZ |
NPI Number: | 1124027859 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 13348 |
Business Practice Address: | Expreso Trujillo Alto Km 4.4 San Miguel Medical - Suite 204 Plaza San Miguel Trujillo Alto, PR - 00976 |
Business Phone Number: | 7877487120 |
Business Fax Number: | 7877487105 |
Mailing Address: | Po Box 193868, SAN JUAN |
State: | PR |
Postal Code: | 009193868 |
Phone Number: | 7877487120 |
Fax Number: | 7877487105 |
NPI Enumeration Date: | 07/15/2005 |
NPI Last Update Date: | 01/13/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 13348 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |