Provider Demographics
NPI:1093723579
Name:PEREZ DEL RIO, MARIA I (MD)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:I
Last Name:PEREZ DEL RIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:JARDINES DE VEGA BAJA
Mailing Address - Street 2:CALLE JARDINES DE GIRASOLES # 355
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693
Mailing Address - Country:US
Mailing Address - Phone:787-883-4280
Mailing Address - Fax:787-883-4280
Practice Address - Street 1:CALLE GORGTTI #11
Practice Address - Street 2:
Practice Address - City:VEGA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00692
Practice Address - Country:US
Practice Address - Phone:787-883-4280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9731208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR100011OtherMMM
PR1727Medicaid
PR100011OtherMMM
PR0081886Medicare ID - Type Unspecified