Provider Demographics
NPI:1841274537
Name:PEROCIER AGUIRRE, MARIEANNE (MD)
Entity type:Individual
Prefix:MISS
First Name:MARIEANNE
Middle Name:
Last Name:PEROCIER AGUIRRE
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:PO BOX 195326
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-5326
Mailing Address - Country:US
Mailing Address - Phone:787-758-4810
Mailing Address - Fax:
Practice Address - Street 1:132 CALLE MAYAGUEZ
Practice Address - Street 2:URB PEREZ MORIS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-5100
Practice Address - Country:US
Practice Address - Phone:787-758-4810
Practice Address - Fax:787-282-6023
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR61592084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG90634Medicare UPIN
PR00B0153Medicare ID - Type Unspecified