Provider Demographics
NPI:1225042393
Name:PEREZ-GUTIERREZ, ROBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:
Last Name:PEREZ-GUTIERREZ
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:URB MONTEHIEDRA
Mailing Address - Street 2:113 CALLE GUARAGUAO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-7101
Mailing Address - Country:US
Mailing Address - Phone:787-767-4100
Mailing Address - Fax:787-767-4119
Practice Address - Street 1:369 CALLE DE DIEGO
Practice Address - Street 2:SUITE 408, TORRE SAN FRANCISCO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00923-3003
Practice Address - Country:US
Practice Address - Phone:787-767-4100
Practice Address - Fax:787-767-4119
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8364207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0080329AMedicare PIN
PRD34267Medicare UPIN
PR0080329Medicare PIN