Provider Demographics
NPI:1033480843
Name:DANIEL PATRON PEREZ PSC
Entity Type:Organization
Organization Name:DANIEL PATRON PEREZ PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATRON - PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-746-2331
Mailing Address - Street 1:PO BOX 8248
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-8248
Mailing Address - Country:US
Mailing Address - Phone:787-746-2331
Mailing Address - Fax:787-745-2165
Practice Address - Street 1:202 CALLE GAUTIER BENITEZ
Practice Address - Street 2:CONSOLIDATED MALL - SUITE 61
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-5527
Practice Address - Country:US
Practice Address - Phone:787-746-2331
Practice Address - Fax:787-745-2165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6158174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
W55454Medicare UPIN