Provider Demographics
NPI:1427687433
Name:DEL ANGEL PEREZ, JOSE A SR
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:A
Last Name:DEL ANGEL PEREZ
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1824 AMARILLO ST NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-6104
Mailing Address - Country:US
Mailing Address - Phone:859-912-9141
Mailing Address - Fax:
Practice Address - Street 1:1824 AMARILLO ST NW
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-6104
Practice Address - Country:US
Practice Address - Phone:859-912-9141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-02
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No372500000XNursing Service Related ProvidersChore Provider