Provider Demographics
NPI:1306991641
Name:PEREZ, NYDIA P (OD)
Entity type:Individual
Prefix:DR
First Name:NYDIA
Middle Name:P
Last Name:PEREZ
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:CLEMSON ST. UNIVERSITY GARDENS
Mailing Address - Street 2:321B
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-4020
Mailing Address - Country:US
Mailing Address - Phone:787-448-0266
Mailing Address - Fax:787-795-5109
Practice Address - Street 1:LOS DOMINICOS SHOPPING CENTER
Practice Address - Street 2:SUITE 19
Practice Address - City:LEVITTOWN
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-795-5109
Practice Address - Fax:787-795-5109
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2012-02-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR344152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist