Provider Demographics
NPI:1295848919
Name:PEREZ-GONZALEZ, DALIA ENID (MD)
Entity Type:Individual
Prefix:DR
First Name:DALIA
Middle Name:ENID
Last Name:PEREZ-GONZALEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1456 PARK AVE W
Mailing Address - Street 2:SUITE N
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-2700
Mailing Address - Country:US
Mailing Address - Phone:440-526-4602
Mailing Address - Fax:440-526-4664
Practice Address - Street 1:1456 PARK AVENUE WEST
Practice Address - Street 2:SUITE N
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-2700
Practice Address - Country:US
Practice Address - Phone:419-529-4602
Practice Address - Fax:419-529-4664
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR88322084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry