# PRIME OTOLARYNGOLOGY SERVICES, PSC

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

## Provider details

- **NPI number:** 1821542234
- **Authorized official:** DR. LISETTE YVONNE PEREZ M.D. (PRESIDENT)
- **Authorized official phone:** (787) 706-4334

## Contact information

- **Practice address:** 1510 AVE F.D. ROOSEVELT, MEZZANINE SUITE B, GUAYNABO, PR 00968-2602
- **Practice address phone:** (787) 706-4334
- **Practice address fax:** (787) 749-0993
- **Mailing address:** PO BOX 1036, GUAYNABO, PR 00970-1036
- **Mailing address phone:** (787) 706-4334
- **Mailing address fax:** (787) 749-0993

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Y00000X | Otolaryngology Physician | 11652 | PR | Yes |

## Other

- **Enumeration date:** 08/15/2016
- **Last updated:** 08/15/2016