Provider Demographics
NPI:1831145143
Name:PEREZ RODRIGUEZ, JULIO (MD)
Entity Type:Individual
Prefix:
First Name:JULIO
Middle Name:
Last Name:PEREZ RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JULIO
Other - Middle Name:
Other - Last Name:PEREZ RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:221 URAYOAN
Mailing Address - Street 2:LOS CACIQUES
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-8714
Mailing Address - Country:US
Mailing Address - Phone:778-777-7353
Mailing Address - Fax:787-777-3768
Practice Address - Street 1:221 CALLE URAYOAN
Practice Address - Street 2:LOS CACIQUES
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987-8714
Practice Address - Country:US
Practice Address - Phone:787-768-7026
Practice Address - Fax:787-768-7026
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14710146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR21445 PEOtherS.S.S.
PRH81530Medicare UPIN
PR21445Medicare ID - Type UnspecifiedMEDICARE PROVIDER