Provider Demographics
NPI:1336212265
Name:PEREZ, MAGALI DEL CARMEN (MD)
Entity Type:Individual
Prefix:
First Name:MAGALI
Middle Name:DEL CARMEN
Last Name:PEREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB.VALLE VERDE
Mailing Address - Street 2:PASEO REAL 1032
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-3504
Mailing Address - Country:US
Mailing Address - Phone:787-396-3877
Mailing Address - Fax:
Practice Address - Street 1:URB. VALLE VERDE
Practice Address - Street 2:#1032 PASEO REAL
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-3504
Practice Address - Country:US
Practice Address - Phone:787-396-3877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7724208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE-81942Medicare UPIN
PR002617612 AAMedicare ID - Type UnspecifiedGENERALIST DOCTOR