Provider Demographics
NPI:1952817645
Name:MEDRANO PEREZ, JOSE R III (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:R
Last Name:MEDRANO PEREZ
Suffix:III
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:I23 CALLE 1
Mailing Address - Street 2:ESTANCIAS DE SAN FERNANDO
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985
Mailing Address - Country:US
Mailing Address - Phone:787-225-5959
Mailing Address - Fax:
Practice Address - Street 1:CARR 349 KM 2.7 CERRO LAS MESAS
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-8321
Practice Address - Country:US
Practice Address - Phone:787-834-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-18
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19853208D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice