Provider Demographics
NPI:1295191971
Name:ROSA I PEREZ TORRES, MD
Entity Type:Organization
Organization Name:ROSA I PEREZ TORRES, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDITARICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:I
Authorized Official - Last Name:PEREZ TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-292-8615
Mailing Address - Street 1:29 CALLE BASILIO CATALA
Mailing Address - Street 2:710 COND PRADOS DEL MONTE
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00971-7601
Mailing Address - Country:US
Mailing Address - Phone:787-292-9861
Mailing Address - Fax:
Practice Address - Street 1:29 CALLE BASILIO CATALA
Practice Address - Street 2:710 COND PRADOS DEL MONTE
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00971-7601
Practice Address - Country:US
Practice Address - Phone:787-292-9861
Practice Address - Fax:787-292-9861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-11
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7663208000000X, 302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No302F00000XManaged Care OrganizationsExclusive Provider OrganizationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1497951669Medicare PIN