Provider Demographics
NPI:1982610697
Name:PEREZ BERRIOS, YANESA M (MD)
Entity Type:Individual
Prefix:MRS
First Name:YANESA
Middle Name:M
Last Name:PEREZ BERRIOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:YANESA
Other - Middle Name:M
Other - Last Name:PEREZ BERRIOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 7886
Mailing Address - Street 2:PMB 367
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-7886
Mailing Address - Country:US
Mailing Address - Phone:787-765-1039
Mailing Address - Fax:787-765-6197
Practice Address - Street 1:200 AVE WINSTON CHURCHILL
Practice Address - Street 2:W CHURCHILL 2000 BLDG OF 201
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00926-6651
Practice Address - Country:US
Practice Address - Phone:787-765-1039
Practice Address - Fax:787-765-6197
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11506207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0084258Medicare ID - Type Unspecified
G40342Medicare UPIN