Provider Demographics
NPI:1235268772
Name:PEREZ PEREZ, PASCUAL ARNALDO (PHD)
Entity Type:Individual
Prefix:DR
First Name:PASCUAL
Middle Name:ARNALDO
Last Name:PEREZ PEREZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE A URB MARBELLA
Mailing Address - Street 2:#23
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603-0000
Mailing Address - Country:US
Mailing Address - Phone:787-882-8231
Mailing Address - Fax:787-882-0295
Practice Address - Street 1:CALLE RUIZ BELVIS
Practice Address - Street 2:#2
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603-0000
Practice Address - Country:US
Practice Address - Phone:787-882-0295
Practice Address - Fax:787-882-0295
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1609103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR16-1609OtherMEDICAL CARD SYSTEM
PR2245OtherHUMANA
PR1199OtherINTERNATIONAL MEDICAL CAR
PR105515OtherFHC VALUE OPTIONS