Provider Demographics
NPI:1700077005
Name:PEREZ VILLAMIL, RALPH (MD)
Entity Type:Individual
Prefix:
First Name:RALPH
Middle Name:
Last Name:PEREZ VILLAMIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 WASHINGTON ST
Mailing Address - Street 2:APARTMENT 803
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-2154
Mailing Address - Country:US
Mailing Address - Phone:787-725-3903
Mailing Address - Fax:787-723-3448
Practice Address - Street 1:60 WASHINGTON ST
Practice Address - Street 2:APARTMENT 803
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-2154
Practice Address - Country:US
Practice Address - Phone:787-725-3903
Practice Address - Fax:787-723-3448
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2842207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0093385Medicare PIN
C83773Medicare UPIN