Provider Demographics
NPI:1164223772
Name:CENTENO PEREZ, ADYANIS CORAL
Entity type:Individual
Prefix:
First Name:ADYANIS
Middle Name:CORAL
Last Name:CENTENO PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 CALLE UN APT 108
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00971-7402
Mailing Address - Country:US
Mailing Address - Phone:787-610-7060
Mailing Address - Fax:
Practice Address - Street 1:CALLE DR. JOSE CELSO BARBOSA
Practice Address - Street 2:UNIVERSITY OF PUERTO RICO, MEDICAL SCIENCES CAMPUS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-758-2525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program