Provider Demographics
NPI:1568463180
Name:DIAZ PEREZ, SONIA ESTHER (MD)
Entity type:Individual
Prefix:DR
First Name:SONIA
Middle Name:ESTHER
Last Name:DIAZ PEREZ
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:735 AVE PONE DE LEON
Mailing Address - Street 2:TORRE MEDICA AUXILIO MUTUO STE 511
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00917
Mailing Address - Country:US
Mailing Address - Phone:787-763-5500
Mailing Address - Fax:787-763-5621
Practice Address - Street 1:735 AVE PONCE DE LEON
Practice Address - Street 2:TORRE MEDICA AUXILUO MUTUO STE 511
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-5022
Practice Address - Country:US
Practice Address - Phone:787-763-5500
Practice Address - Fax:787-763-5621
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-04
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR11810207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG41341Medicare UPIN