Lissette Enid Perez, M.D.
Individual provider Active NPI General Practice Physician · Comerio, PR
NPI 1780679597 · NPPES record last updated Jun 25, 2010
Key facts
- NPI
- 1780679597
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 12185 (PR)
- Practice address
- 1A Calle Jose de Diego
Comerio, PR 00782-2532 - Phone
- (787) 875-0330
- Fax
- (787) 875-0330
- NPI assigned
- Sep 19, 2005
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040127000072 | PR | Practitioner - General Practice | 6204738933 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 12185 | PR | Yes |
Addresses
Primary practice location
1A Calle Jose de Diego
Comerio, PR 00782-2532
Mailing address
19 Urb. Treasure Island Gardens
Cidra, PR 00739
Phone (787) 875-0330
Other providers in Comerio, PR
- Dariana Minerva Nunez-Medina
- Nur Salud Comunitaria Inc
- Juan Diego Ocasio
- Gladelis Ortega Cumba
- Claribel Ortiz
- Concepcion C Quintero
- RB Primed Center LLC
- RC Dental Group LLC
- Dayana M Reyes Reyes
- Melizza Reyes Velez
All providers in Comerio, PR · General Practice Physician in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.