Provider Demographics
NPI:1043227333
Name:PEREZ -QUIROS, JOSE RAFAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:RAFAEL
Last Name:PEREZ -QUIROS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:74 CALLE REINA ALEXANDRA
Mailing Address - Street 2:URB. LA VILLA DE TORRIMAR
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-3273
Mailing Address - Country:US
Mailing Address - Phone:787-731-8941
Mailing Address - Fax:787-731-8941
Practice Address - Street 1:52 CALLE MAYAGUEZ
Practice Address - Street 2:
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00917-4915
Practice Address - Country:US
Practice Address - Phone:787-764-0273
Practice Address - Fax:787-764-0273
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8725208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR067858OtherLA CRUZ AZUL DE PR
PR8000312OtherHUMANA
PR686OtherAMERICAN HEALTH MEDICARE
PR82110PEOtherTRIPLE S, INC.
PR204106OtherPREFERRED HEALTH
PR82110PEOtherTRIPLE S, INC. REFORMA
PR82110PEOtherMEDICARE OPTIMA SSS
PR7983OtherFIRST MEDICAL IMC
PR82110PEOtherTRIPLE S, INC. REFORMA
PR0082110Medicare PIN