Individual
EVELINA VEGA PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
2300 GARRISON BLVD, SUITE 190, BALTIMORE, MD 21216-2335
(410) 566-2501
(410) 566-3025
Mailing address
2300 GARRISON BLVD, SUITE 190, BALTIMORE, MD 21216-2335
(410) 566-2501
(410) 566-3025
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
19529
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E705
FEDERAL BLUECROSS/SHIELD
MD
01
—
LV17
CAREFIRST BLUECROSS/SHIEL
MD
Enumeration date
05/05/2006
Last updated
11/05/2008
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