Individual provider Active NPI

Gabriel Daniel Perez Cordero

  • Internal Medicine Physician
  • San Juan, PR
National Provider Identifier
1073145116
Registry record updated Nov 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
16368 Issued in PR
Practice address
School of Medicine University of Puerto Rico
Medical Sciences Campus
San Juan, PR 00936-5067
Phone
(787) 758-2525
NPI assigned
Feb 6, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 16368 PR Primary

Addresses

Primary practice location

School of Medicine University of Puerto Rico
Medical Sciences Campus
San Juan, PR 00936-5067

Mailing address

Urb Mansion del Mar
Calle Pelicano, Mm141
Toa Baja, PR 00949
Phone (787) 363-0167

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
16368PRMDInternal Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1580947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669507200000",
    "number": "1073145116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB MANSION DEL MAR",
            "address_2": "CALLE PELICANO, MM141",
            "city": "TOA BAJA",
            "state": "PR",
            "postal_code": "00949",
            "telephone_number": "787-363-0167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SCHOOL OF MEDICINE UNIVERSITY OF PUERTO RICO",
            "address_2": "MEDICAL SCIENCES CAMPUS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009365067",
            "telephone_number": "787-758-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ CORDERO",
        "first_name": "GABRIEL",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-06",
        "last_updated": "2022-11-27",
        "certification_date": "2022-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "16368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.