Provider Demographics
NPI:1013309186
Name:PEREZ MATAMOROS MEDICAL SERVICES LLC
Entity Type:Organization
Organization Name:PEREZ MATAMOROS MEDICAL SERVICES LLC
Other - Org Name:PEREZ MEDICAL SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:J
Authorized Official - Last Name:PEREZ MATAMOROS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-243-0498
Mailing Address - Street 1:PO BOX 9206
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00908-9206
Mailing Address - Country:US
Mailing Address - Phone:787-243-0498
Mailing Address - Fax:
Practice Address - Street 1:CARR 14 KM 0.3
Practice Address - Street 2:BO RINCON SECTOR LOMAS
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736
Practice Address - Country:US
Practice Address - Phone:787-243-0498
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-26
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty