Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 18174 | PR |
NPI | 1033439013 |
---|---|
Provider Name | Dr. Jose Julio Perez Matamoros |
First Address | San Juan, PR 00908-0206 |
Second Address | Caguas, PR 00725-0000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2010 |
Last Update Date | 06/11/2014 |