Provider Demographics
NPI:1437451192
Name:PEREZ, JUAN MIGUEL
Entity Type:Individual
Prefix:MR
First Name:JUAN
Middle Name:MIGUEL
Last Name:PEREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 VIA PEDREGAL APT 805
Mailing Address - Street 2:MONTECILLO 1 ENCANTADA
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-6609
Mailing Address - Country:US
Mailing Address - Phone:787-221-3998
Mailing Address - Fax:
Practice Address - Street 1:1 VIA PEDREGAL APT 805
Practice Address - Street 2:MONTECILLO 1 ENCANTADA
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976-6609
Practice Address - Country:US
Practice Address - Phone:787-221-3998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-30
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports