Provider Demographics
NPI:1609077882
Name:PEREZ, MIGUEL HERNANDEZ SR (MD)
Entity Type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:HERNANDEZ
Last Name:PEREZ
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MIGUEL
Other - Middle Name:HERNANDEZ
Other - Last Name:PEREZ
Other - Suffix:SR
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1630 SANTA EDUBIJES SAGRADO CORAZON
Mailing Address - Street 2:
Mailing Address - City:RIO PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00927-0000
Mailing Address - Country:US
Mailing Address - Phone:787-760-1376
Mailing Address - Fax:787-760-1376
Practice Address - Street 1:1630 SANTA EDUBIJES SAGRADO CORAZON
Practice Address - Street 2:
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00927-0000
Practice Address - Country:US
Practice Address - Phone:787-760-1376
Practice Address - Fax:787-760-1376
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7502208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice