Provider Demographics
NPI:1821065855
Name:PEREZ GRAU, MARIA ELOISA (MD)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ELOISA
Last Name:PEREZ GRAU
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:PO BOX 11367
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00910
Mailing Address - Country:US
Mailing Address - Phone:787-946-4401
Mailing Address - Fax:787-946-4490
Practice Address - Street 1:1429 AVE FERNANDEZ JUNCOS
Practice Address - Street 2:SUITE 4
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909-2658
Practice Address - Country:US
Practice Address - Phone:787-946-4401
Practice Address - Fax:787-946-4490
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13570207RH0003X
PR13270207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty