Provider Demographics
NPI:1134983976
Name:PEREZ, JONATHAN ALEXIS (DC)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:ALEXIS
Last Name:PEREZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 CALLE LOS INGENIEROS
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682-7747
Mailing Address - Country:US
Mailing Address - Phone:787-616-5681
Mailing Address - Fax:
Practice Address - Street 1:#63 W CALLE MENDEZ VIGO EDIFICIO TORRE DE HOSTOS 1D
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-805-0707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14878111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor