Provider Demographics
NPI:1689688202
Name:PEREZ BRIONES, JULIO A
Entity type:Individual
Prefix:
First Name:JULIO
Middle Name:A
Last Name:PEREZ BRIONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CN6 CALLE 9
Mailing Address - Street 2:URB. BAIROA
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-1422
Mailing Address - Country:US
Mailing Address - Phone:787-381-7458
Mailing Address - Fax:
Practice Address - Street 1:CALLE BALDORIOTY #52
Practice Address - Street 2:
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705
Practice Address - Country:US
Practice Address - Phone:787-991-3222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14295208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
H84384Medicare UPIN
PR0021457Medicare ID - Type Unspecified