# DR. OBED PEREZ GONZALEZ CSP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134598378
- **Authorized official:** DR. OBED PEREZ GONZALEZ MD (PRESIDENT)
- **Authorized official phone:** (787) 892-0944

## Contact information

- **Practice address:** 100 AVE. HERNAN ALVAREZ, PLAZA METROPOLITANA SUITE 207, SAN GERMAN, PR 00683
- **Practice address phone:** (787) 892-0944
- **Practice address fax:** (787) 892-0944
- **Mailing address:** PO BOX 473, SAN GERMAN, PR 00683-0473
- **Mailing address phone:** (787) 892-0944
- **Mailing address fax:** (787) 892-0944

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 9517 | PR | Yes |

## Other

- **Enumeration date:** 09/17/2015
- **Last updated:** 09/17/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 84236 | MEDICARE | PR |