Individual
MARISOL M MUBARAK PERDOMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
11177
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0500133
HUMANA HEALTH PLANS
PR
01
—
217023
PREFERRED HEALTH
PR
01
—
600108
MEDICARE Y MUCHO MAS
PR
01
—
83360
TRIPLE S
PR
Enumeration date
11/16/2006
Last updated
11/20/2023
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