Provider Demographics
NPI:1225656226
Name:PEREZ GUTIERREZ, MILEIDYS (PA)
Entity Type:Individual
Prefix:DR
First Name:MILEIDYS
Middle Name:
Last Name:PEREZ GUTIERREZ
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 AVE GAUTIER BENITEZ, CONSOLIDATED MEDICAL PLAZA
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-744-5278
Mailing Address - Fax:
Practice Address - Street 1:201 AVE GAUTIER BENITEZ, CONSOLIDATED MEDICAL PLAZA
Practice Address - Street 2:SUITE 101
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-744-5278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-07
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR000555-P.A.363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical