Provider Demographics
NPI:1932131067
Name:PEREZ, DENNIS E (MD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:E
Last Name: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 1508
Mailing Address - Street 2:
Mailing Address - City:VEGA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00692-1508
Mailing Address - Country:US
Mailing Address - Phone:787-270-0520
Mailing Address - Fax:787-270-0530
Practice Address - Street 1:1 CALLE MARGINAL STE 103
Practice Address - Street 2:URB SANTA RITA 1 CALLE MARGINAL
Practice Address - City:VEGA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00692-6797
Practice Address - Country:US
Practice Address - Phone:787-270-0520
Practice Address - Fax:787-270-0530
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR119552085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH75247Medicare UPIN