Provider Demographics
NPI:1831167964
Name:PEREZ DE JESUS, ARMANDO LUIS (MD)
Entity type:Individual
Prefix:DR
First Name:ARMANDO
Middle Name:LUIS
Last Name:PEREZ DE JESUS
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 1:128 CALLE ASHFORD S
Mailing Address - Street 2:ASHFORD MEDICAL PLAZA SUITE 102
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00784-5410
Mailing Address - Country:US
Mailing Address - Phone:787-866-0337
Mailing Address - Fax:787-866-0337
Practice Address - Street 1:128 CALLE ASHFORD S
Practice Address - Street 2:ASHFORD MEDICAL PLAZA SUITE 102
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784-5410
Practice Address - Country:US
Practice Address - Phone:787-866-0337
Practice Address - Fax:787-866-0337
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR96292084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR82659OtherSSS
PR060593OtherCA
PR060593OtherCA
PRH55308Medicare UPIN