Provider Demographics
NPI:1386813970
Name:KUILAN PEREZ, IRIS LILIANA (PSY D)
Entity Type:Individual
Prefix:DR
First Name:IRIS
Middle Name:LILIANA
Last Name:KUILAN PEREZ
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 33 BOX 5168
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-9603
Mailing Address - Country:US
Mailing Address - Phone:787-405-6504
Mailing Address - Fax:
Practice Address - Street 1:51 URB CATALANA
Practice Address - Street 2:51 URB CATALANA
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617-2773
Practice Address - Country:US
Practice Address - Phone:787-846-5101
Practice Address - Fax:787-852-1105
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-27
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TB0200X
PR2409103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2409OtherLICENSE NO.