Provider Demographics
NPI:1821060971
Name:PEREZ, LINES MARIA (MD)
Entity Type:Individual
Prefix:MS
First Name:LINES
Middle Name:MARIA
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:BULEVAR PASEOS
Mailing Address - Street 2:MSC 342 SUITE 112
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-645-3309
Mailing Address - Fax:
Practice Address - Street 1:389 CALLE ELEONOR ROOSEVELT
Practice Address - Street 2:HATO REY
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2108
Practice Address - Country:US
Practice Address - Phone:787-250-9701
Practice Address - Fax:787-759-9136
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR131012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH97249Medicare UPIN
PR0020090Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER