Provider Demographics
NPI:1255678132
Name:ARACENA PEREZ, FREDDY (PH D)
Entity Type:Individual
Prefix:DR
First Name:FREDDY
Middle Name:
Last Name:ARACENA PEREZ
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25034
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00928-5034
Mailing Address - Country:US
Mailing Address - Phone:787-226-5324
Mailing Address - Fax:
Practice Address - Street 1:331 CALLE COLL Y TOSTE
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-4026
Practice Address - Country:US
Practice Address - Phone:787-226-5324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR004654103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical