Provider Demographics
NPI:1376641795
Name:PEREZ RIVERA, YARELIS MARIE (MD)
Entity Type:Individual
Prefix:
First Name:YARELIS
Middle Name:MARIE
Last Name:PEREZ RIVERA
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:HH14 CALLE 4A
Mailing Address - Street 2:ALTURAS DE VILLAS DE CASTRO
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-4704
Mailing Address - Country:US
Mailing Address - Phone:787-746-8704
Mailing Address - Fax:
Practice Address - Street 1:HH14 CALLE 4A
Practice Address - Street 2:ALTURAS DE VILLAS DE CASTRO
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-4704
Practice Address - Country:US
Practice Address - Phone:787-746-8704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16651208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice