Provider Demographics
NPI:1497821326
Name:PEREZ, VILMA (MD)
Entity Type:Individual
Prefix:DR
First Name:VILMA
Middle Name:
Last Name: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:PO BOX 994
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-0994
Mailing Address - Country:US
Mailing Address - Phone:787-854-5752
Mailing Address - Fax:787-884-6619
Practice Address - Street 1:200 CARR 2 TORRE MEDICA I DR PEDRO BLANCO LUGO
Practice Address - Street 2:SUITE 210
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-4661
Practice Address - Country:US
Practice Address - Phone:787-854-5752
Practice Address - Fax:787-884-6619
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12295207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG41290Medicare UPIN
PR0088646Medicare ID - Type Unspecified