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Individual

MARISOL M MUBARAK PERDOMO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1451 AVE ASHFORD ESQ NAIRM, ESTACIONAMIENTO LA GALERIA SUITE 611, SAN JUAN, PR 00907-1567
(787) 724-8945
Mailing address
CALLE BIENTEVEO NUM 94, MONTEHIEDRA, SAN JUAN, PR 00926
(787) 724-8945

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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