Provider Demographics
NPI:1932206257
Name:PEREZ-FERNANDEZ, CENIA S (MD)
Entity Type:Individual
Prefix:
First Name:CENIA
Middle Name:S
Last Name:PEREZ-FERNANDEZ
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 1:1133 CALLE 9
Mailing Address - Street 2:VILLA NEVAREZ
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-5333
Mailing Address - Country:US
Mailing Address - Phone:787-274-0731
Mailing Address - Fax:787-274-0731
Practice Address - Street 1:1133 CALLE 9
Practice Address - Street 2:VILLA NEVAREZ
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-5333
Practice Address - Country:US
Practice Address - Phone:787-274-0731
Practice Address - Fax:787-274-0731
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9416208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR26083OtherTRIPLE S
PR0026083Medicare ID - Type Unspecified
PR26083OtherTRIPLE S