Provider Demographics
NPI:1174832414
Name:PERDOMO MONTES, HUGO (MD)
Entity Type:Individual
Prefix:DR
First Name:HUGO
Middle Name:
Last Name:PERDOMO MONTES
Suffix:
Gender:M
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:HC 4 BOX 12936
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-9593
Mailing Address - Country:US
Mailing Address - Phone:787-892-2262
Mailing Address - Fax:
Practice Address - Street 1:HC 4 BOX 12936
Practice Address - Street 2:
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-9593
Practice Address - Country:US
Practice Address - Phone:787-892-2262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-05
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18045208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice