Provider Demographics
NPI:1821274846
Name:PEREZ-QUINONES, LIBERTARIO (PHD)
Entity Type:Individual
Prefix:DR
First Name:LIBERTARIO
Middle Name:
Last Name:PEREZ-QUINONES
Suffix:
Gender:M
Credentials:PHD
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 2017
Mailing Address - Street 2:
Mailing Address - City:LAS PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00771-2017
Mailing Address - Country:US
Mailing Address - Phone:787-249-9960
Mailing Address - Fax:787-746-4787
Practice Address - Street 1:52 CALLE RUIZ BELVIS
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-3586
Practice Address - Country:US
Practice Address - Phone:787-733-0331
Practice Address - Fax:787-746-4787
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-21
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR001486103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical