Provider Demographics
NPI:1912042243
Name:PEREZ, JENNIFER E (PT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:E
Last Name:PEREZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB LOS PINOS D4
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791
Mailing Address - Country:US
Mailing Address - Phone:787-930-4906
Mailing Address - Fax:
Practice Address - Street 1:266 AVE LAURO PINERO
Practice Address - Street 2:
Practice Address - City:CEIBA
Practice Address - State:PR
Practice Address - Zip Code:00735-2706
Practice Address - Country:US
Practice Address - Phone:787-885-3010
Practice Address - Fax:787-885-1595
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4284247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other