Provider Demographics
NPI:1568408797
Name:PEREZ, ANGEL (MD)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:
Last Name:PEREZ
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 422
Mailing Address - Street 2:
Mailing Address - City:SABANA SECA
Mailing Address - State:PR
Mailing Address - Zip Code:00952-0422
Mailing Address - Country:US
Mailing Address - Phone:787-884-6189
Mailing Address - Fax:
Practice Address - Street 1:EDIFICIO MEDICO PEDRO BLANCO LUGO
Practice Address - Street 2:TORRE MEDICA OFICINA 314 DR CENTER HOSPITAL
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-0000
Practice Address - Country:US
Practice Address - Phone:787-884-6189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10890207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR89031OtherTRIPLE S
PR2901307OtherACAA
PR5028OtherPROSSAM
PR600072OtherMEDICARE Y MUCHO MAS
PR9590037OtherHUMANA INSURANCE
PR060452OtherCRUZ AZUL DE PR
PR1929OtherFIRST MEDICAL
PR218086OtherPREFERRED HEALTH
PR5028OtherPROSSAM
PR9590037OtherHUMANA INSURANCE