Provider Demographics
NPI:1619936697
Name:ROSARIO PEREZ, DENISE (PT PHYSICAL THERAPIS)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:
Last Name:ROSARIO PEREZ
Suffix:
Gender:F
Credentials:PT PHYSICAL THERAPIS
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 9241
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-9241
Mailing Address - Country:US
Mailing Address - Phone:787-995-4789
Mailing Address - Fax:787-995-6207
Practice Address - Street 1:MAGNOLIA AVE 0-2 URB MAGNOLIA GARDENS
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00960-9241
Practice Address - Country:US
Practice Address - Phone:787-995-4789
Practice Address - Fax:787-995-6207
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1016225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
60079Medicare ID - Type Unspecified