Provider Demographics
NPI:1467173658
Name:PEREZ TIJERINA, DANIEL ALEXANDRO (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ALEXANDRO
Last Name:PEREZ TIJERINA
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:PO BOX 1942
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-1942
Mailing Address - Country:US
Mailing Address - Phone:787-233-3177
Mailing Address - Fax:
Practice Address - Street 1:CALLE HOSTOS 47 ESQUINA BRAU EL CIBAO
Practice Address - Street 2:
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623
Practice Address - Country:US
Practice Address - Phone:787-255-0200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-07
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22988208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice