Provider Demographics
NPI:1245347111
Name:PEREZ-SANCHEZ, JOHNNY H (MD)
Entity type:Individual
Prefix:
First Name:JOHNNY
Middle Name:H
Last Name:PEREZ-SANCHEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 71325
Mailing Address - Street 2:SUITE 164
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-8425
Mailing Address - Country:US
Mailing Address - Phone:787-706-1344
Mailing Address - Fax:787-793-2308
Practice Address - Street 1:1669 AVE AMERICO MIRANDA
Practice Address - Street 2:URB LAS LOMAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-2429
Practice Address - Country:US
Practice Address - Phone:787-706-1344
Practice Address - Fax:787-793-2308
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2012-11-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR12094207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH55595Medicare UPIN