Organization
MAYAGUEZ SPORT MEDICINE L L C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARLOS J PEREZ LOPEZ M.D. (PRESIDENT)
(787) 464-2788
Entity
Organization
Contact information
Practice address
875 AVE HOSTOS, MAYAGUEZ, PR 00680-1529
(787) 652-3800
(787) 652-3802
Mailing address
PO BOX 418, MAYAGUEZ, PR 00681-0418
(787) 652-3800
(787) 652-3802
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
17246
PR
Other
Enumeration date
03/19/2014
Last updated
03/19/2014
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