1952631152 NPI number — MRS. KAREN PEREZ HERNANDEZ P.T

Table of content: MRS. KAREN PEREZ HERNANDEZ P.T (NPI 1952631152)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952631152 NPI number — MRS. KAREN PEREZ HERNANDEZ P.T

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PEREZ HERNANDEZ
Provider First Name:
KAREN
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
P.T
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952631152
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/12/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 7004
Provider Second Line Business Mailing Address:
PMB 181
Provider Business Mailing Address City Name:
SAN SEBASTIAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00685-9004
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-366-7058
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BARRIO SONADOR SECTOR LOS RAMOS CARR. 497 KM2.3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN SEBASTIAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00685-9865
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-366-7058
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/11/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  1275 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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