Provider Demographics
NPI:1922161645
Name:PEREZ, MARIA D (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:D
Last Name:PEREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 6232
Mailing Address - Street 2:LOIZA STATION
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00914-6232
Mailing Address - Country:US
Mailing Address - Phone:787-740-1178
Mailing Address - Fax:787-740-1193
Practice Address - Street 1:CALLE 2 J-20
Practice Address - Street 2:EXT. HERMANAS DAVILAS
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-740-1178
Practice Address - Fax:787-740-1193
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR7941207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRD34254Medicare UPIN
80027Medicare PIN