Provider Demographics
NPI:1790823946
Name:PEREZ LORAN, EDWIN H (MD)
Entity type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:H
Last Name:PEREZ LORAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:URB COSTA BRAVA CALLE FINCHE 294
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662
Mailing Address - Country:US
Mailing Address - Phone:787-413-5736
Mailing Address - Fax:787-884-4022
Practice Address - Street 1:B23 CALLE 3
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-5409
Practice Address - Country:US
Practice Address - Phone:787-413-5736
Practice Address - Fax:787-884-4022
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16581208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice