Provider Demographics
NPI:1861021917
Name:CORCHADO PEREZ, JOSE ANGEL (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ANGEL
Last Name:CORCHADO PEREZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:649 CALLE COMUNAL
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-4242
Mailing Address - Country:US
Mailing Address - Phone:787-515-2876
Mailing Address - Fax:
Practice Address - Street 1:649 CALLE COMUNAL
Practice Address - Street 2:
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-4242
Practice Address - Country:US
Practice Address - Phone:787-515-2876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-01
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH13253111N00000X
PR765225100000X, 111N00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty