Provider Demographics
NPI:1396319638
Name:PEREZ JIMENEZ, KARLA MARIE (MD)
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:MARIE
Last Name:PEREZ JIMENEZ
Suffix:
Gender:F
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:DH-14 CALLE LLANURAS
Mailing Address - Street 2:URB. RIO HONDO IV
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:787-478-5152
Mailing Address - Fax:
Practice Address - Street 1:DH-14 CALLE LLANURAS
Practice Address - Street 2:URB. RIO HONDO IV
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-478-5152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22851208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice