Provider Demographics
NPI:1912194598
Name:PEREZ-DEL PILAR, EDWIN JEMAL (OD)
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:JEMAL
Last Name:PEREZ-DEL PILAR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AVE MCLEARY
Mailing Address - Street 2:1801 COND. BEACH COURT APT. #602
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00911-1266
Mailing Address - Country:US
Mailing Address - Phone:787-263-9079
Mailing Address - Fax:
Practice Address - Street 1:AVE MCLEARY
Practice Address - Street 2:1801 COND. BEACH COURT APT. #602
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00911-1266
Practice Address - Country:US
Practice Address - Phone:787-263-9079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR485-133152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist