Provider Demographics
NPI:1346423720
Name:PEREZ-ACOSTA, SERGIO (MD)
Entity Type:Individual
Prefix:DR
First Name:SERGIO
Middle Name:
Last Name:PEREZ-ACOSTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 CALLE ALARCON
Mailing Address - Street 2:URB. MANSIONES DEL GOLF
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-0000
Mailing Address - Country:US
Mailing Address - Phone:787-447-6315
Mailing Address - Fax:
Practice Address - Street 1:28 CALLE ALARCON
Practice Address - Street 2:URB. MANSIONES DEL GOLF
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-0000
Practice Address - Country:US
Practice Address - Phone:787-447-6315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-09
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17042207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRDM247AMedicare PIN