Provider Demographics
NPI:1316930027
Name:PEREZ-TORO, LUIS SANTOS (MD)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:SANTOS
Last Name:PEREZ-TORO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 CALLE SANTA CRUZ
Mailing Address - Street 2:SUITE 314
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-6910
Mailing Address - Country:US
Mailing Address - Phone:787-787-0171
Mailing Address - Fax:787-787-0221
Practice Address - Street 1:73 CALLE SANTA CRUZ
Practice Address - Street 2:SUITE 314
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6910
Practice Address - Country:US
Practice Address - Phone:787-787-0171
Practice Address - Fax:787-787-0221
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-26
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11305207Q00000X, 207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
89514Medicare ID - Type Unspecified
PRG67888Medicare UPIN