Provider Demographics
NPI:1952360562
Name:PEREZ, NELIDA RIVERA (12576)
Entity Type:Individual
Prefix:MS
First Name:NELIDA
Middle Name:RIVERA
Last Name:PEREZ
Suffix:
Gender:F
Credentials:12576
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 9921
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613-9921
Mailing Address - Country:US
Mailing Address - Phone:787-820-1763
Mailing Address - Fax:787-820-5759
Practice Address - Street 1:CARR 129 KM 15.0
Practice Address - Street 2:BO. BAYANEY, HATILLO PR
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659
Practice Address - Country:US
Practice Address - Phone:787-820-1763
Practice Address - Fax:787-820-1763
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12576163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice