Provider Demographics
NPI:1134356579
Name:PEREZ, NORA IVETTE (OD)
Entity type:Individual
Prefix:
First Name:NORA
Middle Name:IVETTE
Last Name:PEREZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:287 CALLE LOS ROBLES
Mailing Address - Street 2:LA CUMBRE
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-5532
Mailing Address - Country:US
Mailing Address - Phone:787-898-9805
Mailing Address - Fax:
Practice Address - Street 1:287 CALLE LOS ROBLES
Practice Address - Street 2:LA CUMBRE
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-5532
Practice Address - Country:US
Practice Address - Phone:787-898-9805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR332152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist