Provider Demographics
NPI:1669447256
Name:PEREZ, CARLOS RAFAEL SR (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:RAFAEL
Last Name:PEREZ
Suffix:SR
Gender:M
Credentials:MD
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Mailing Address - Street 1:INSTITUTO SAN PABLO
Mailing Address - Street 2:66 CALLE STA CRUZ SUITE 304
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:787-522-0836
Mailing Address - Fax:787-522-0837
Practice Address - Street 1:INSTITUTO SAN PABLO
Practice Address - Street 2:66 CALLE STA CRUZ SUITE 304
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-0096
Practice Address - Country:US
Practice Address - Phone:787-522-0836
Practice Address - Fax:787-522-0836
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2019-06-05
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Provider Licenses
StateLicense IDTaxonomies
PR10324207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRF28743Medicare UPIN