Provider Demographics
NPI:1851371819
Name:FRANCIA PEREZ, MARIO N (MD)
Entity Type:Individual
Prefix:
First Name:MARIO
Middle Name:N
Last Name:FRANCIA PEREZ
Suffix:
Gender:M
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 2913
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-2913
Mailing Address - Country:US
Mailing Address - Phone:787-622-0047
Mailing Address - Fax:787-622-0047
Practice Address - Street 1:232 CALLE ELEONOR ROOSEVELT
Practice Address - Street 2:SUITE 213
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3005
Practice Address - Country:US
Practice Address - Phone:787-454-2140
Practice Address - Fax:787-758-8626
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-18
Last Update Date:2016-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15097208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
I29043Medicare UPIN
PR23074Medicare ID - Type Unspecified