Provider Demographics
NPI:1326640137
Name:PEREZ, OBED (NL)
Entity Type:Individual
Prefix:
First Name:OBED
Middle Name:
Last Name:PEREZ
Suffix:
Gender:M
Credentials:NL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 2 BOX 7495
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-9349
Mailing Address - Country:US
Mailing Address - Phone:787-452-8349
Mailing Address - Fax:
Practice Address - Street 1:HSE #3 CARR 455 KM4.3
Practice Address - Street 2:
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627-9349
Practice Address - Country:US
Practice Address - Phone:787-452-8349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR202175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath