Provider Demographics
NPI:1003079757
Name:NOGALES PEREZ, ELENA M (MD)
Entity Type:Individual
Prefix:DR
First Name:ELENA
Middle Name:M
Last Name:NOGALES PEREZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:#2023 CALLE ABERDEEN
Mailing Address - Street 2:COLLEGEVILLE
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-0000
Mailing Address - Country:US
Mailing Address - Phone:787-241-2982
Mailing Address - Fax:
Practice Address - Street 1:PQ26 AVE COMANDANTE
Practice Address - Street 2:COUNTRY CLUB
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983-0000
Practice Address - Country:US
Practice Address - Phone:787-752-3280
Practice Address - Fax:787-752-8920
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2011-08-09
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Provider Licenses
StateLicense IDTaxonomies
PR18204207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR18204OtherLICENSE