Provider Demographics
NPI:1093563074
Name:PEREZ, DENISE
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 CALLE CENTRAL
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-8696
Mailing Address - Country:US
Mailing Address - Phone:787-589-8800
Mailing Address - Fax:787-589-8803
Practice Address - Street 1:CARR. # 2 KM 133.5
Practice Address - Street 2:CENTERPLEX BUILDING SUITE 201
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602
Practice Address - Country:US
Practice Address - Phone:787-589-8800
Practice Address - Fax:787-589-8803
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR830225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist