Individual
JESUS A PEREZ LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 CALLE ELOY TORRES LUGO, URB. EL PRADO, AGUADILLA, PR 00603-5842
(787) 280-3655
(787) 280-2776
Mailing address
PO BOX 5360, SAN SEBASTIAN, PR 00685-5360
(787) 280-3655
(787) 280-2776
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
11959
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
061517
BLUE CROSS BLUE SHIELD
PR
01
—
201560
PREFERRED HEALTH
PR
01
—
8707
FIRST MEDICAL
PR
01
—
88484PE
TRIPLE S
PR
01
—
PALIC
PG3175
PR
Enumeration date
11/03/2005
Last updated
09/08/2010
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