Provider Demographics
NPI:1427734946
Name:PEREZ TORRES, GUILLERMO
Entity type:Individual
Prefix:
First Name:GUILLERMO
Middle Name:
Last Name:PEREZ TORRES
Suffix:
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 1:549 CALLE TULIPA
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693-3607
Mailing Address - Country:US
Mailing Address - Phone:787-549-1869
Mailing Address - Fax:
Practice Address - Street 1:549 CALLE TULIPA
Practice Address - Street 2:
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-3607
Practice Address - Country:US
Practice Address - Phone:787-549-1869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6641971390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program