Provider Demographics
NPI:1407862535
Name:PEREZ-TORRES, JUAN EMILIO (MD)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:EMILIO
Last Name:PEREZ-TORRES
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 1:166 CALLE PELICANO
Mailing Address - Street 2:MANSION DEL MAR
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-3495
Mailing Address - Country:US
Mailing Address - Phone:787-380-1717
Mailing Address - Fax:
Practice Address - Street 1:25 ULISES MARTINEZ
Practice Address - Street 2:ESQUINA MUNOZ MARIN
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00792
Practice Address - Country:US
Practice Address - Phone:787-852-2551
Practice Address - Fax:787-285-1232
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13124207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR20121- PEOtherTRIPLE S HEALTH PLAN
PR9900469OtherHUMANA HEALTH PLAN
PR20121Medicare ID - Type Unspecified
PR9900469OtherHUMANA HEALTH PLAN