Provider Demographics
NPI:1437357621
Name:CORCHADO PEREZ, AMARILIS (MD)
Entity Type:Individual
Prefix:
First Name:AMARILIS
Middle Name:
Last Name:CORCHADO PEREZ
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:PMB 241
Mailing Address - Street 2:1312 AVE. FELIX ALDARONDO
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662
Mailing Address - Country:US
Mailing Address - Phone:787-872-8538
Mailing Address - Fax:787-872-8538
Practice Address - Street 1:CARR #2, CALLE MARGINAL, KM 112.4
Practice Address - Street 2:BO. GUERRERO
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662
Practice Address - Country:US
Practice Address - Phone:787-872-8538
Practice Address - Fax:787-872-8538
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR138952084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1811959794OtherNPI CORPORATION
PRH93412Medicare UPINUPIN NUMBER
PR0021465Medicare ID - Type UnspecifiedMEDICARE ID NUMBER