Provider Demographics
NPI:1740443456
Name:ROSA PEREZ, YANELLY
Entity type:Individual
Prefix:
First Name:YANELLY
Middle Name:
Last Name:ROSA PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3695
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-3695
Mailing Address - Country:US
Mailing Address - Phone:787-658-0260
Mailing Address - Fax:787-658-0260
Practice Address - Street 1:CARR 2 KM 123.7
Practice Address - Street 2:BARR CAIMITAL ALTO
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603-6501
Practice Address - Country:US
Practice Address - Phone:787-658-0260
Practice Address - Fax:787-658-0260
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-03
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5999246QM0706X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist