Provider Demographics
NPI:1003978636
Name:PEREZ ROSARIO, ANNABELLE ITZEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNABELLE
Middle Name:ITZEL
Last Name:PEREZ ROSARIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANNABELLE
Other - Middle Name:ITZEL
Other - Last Name:PEREZ ROSARIO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:P.O BOX 141012
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-1012
Mailing Address - Country:US
Mailing Address - Phone:787-454-1187
Mailing Address - Fax:787-878-0462
Practice Address - Street 1:CALLE SAN JOSE
Practice Address - Street 2:6
Practice Address - City:LARES
Practice Address - State:PR
Practice Address - Zip Code:00669
Practice Address - Country:US
Practice Address - Phone:787-454-1187
Practice Address - Fax:787-878-0462
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16433146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant