Provider Demographics
NPI:1093792178
Name:PEREZ, CIELOMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:CIELOMAR
Middle Name:
Last Name:PEREZ
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 1:1626 CALLE TIGRIS
Mailing Address - Street 2:RIO PIEDRAS HEIGHTS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-2942
Mailing Address - Country:US
Mailing Address - Phone:787-754-1249
Mailing Address - Fax:787-733-4235
Practice Address - Street 1:1626 CALLE TIGRIS
Practice Address - Street 2:RIO PIEDRAS HEIGHTS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-2942
Practice Address - Country:US
Practice Address - Phone:787-717-1466
Practice Address - Fax:787-733-4235
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-29
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR6657207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6657OtherLICENCIA
PR6657OtherLICENCIA