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Individual

IVAN O PEREZ RIVERA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
E15 CALLE DILDO, GUAYNABO, PR 00969-4707
(787) 258-2835
Mailing address
E15 CALLE DILDO, GUAYNABO, PR 00969-4707
(787) 258-2835

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
14312
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14312
LICENSE
PR
Enumeration date
06/06/2007
Last updated
03/04/2008
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