Provider Demographics
NPI:1649629627
Name:DIAZ-PEREZ, KAREN JARELYS (MD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:JARELYS
Last Name:DIAZ-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 1:29 CALLE WASHINGTON STE 703
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-1521
Mailing Address - Country:US
Mailing Address - Phone:787-725-9708
Mailing Address - Fax:787-721-6995
Practice Address - Street 1:CARR 22 CENTRO MEDICO
Practice Address - Street 2:BO MONACILLOS
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00935
Practice Address - Country:US
Practice Address - Phone:787-753-6390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PR21459208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program