Provider Demographics
NPI:1023864592
Name:PEREZ PEREZ, GEOVANNI (PSYD)
Entity type:Individual
Prefix:DR
First Name:GEOVANNI
Middle Name:
Last Name:PEREZ PEREZ
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 CALLE COLOMER SANCHEZ
Mailing Address - Street 2:
Mailing Address - City:UTUADO
Mailing Address - State:PR
Mailing Address - Zip Code:00641-2846
Mailing Address - Country:US
Mailing Address - Phone:787-428-6868
Mailing Address - Fax:
Practice Address - Street 1:58 CALLE COLOMER SANCHEZ
Practice Address - Street 2:
Practice Address - City:UTUADO
Practice Address - State:PR
Practice Address - Zip Code:00641-2846
Practice Address - Country:US
Practice Address - Phone:787-428-6868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7728103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical