Provider Demographics
NPI:1548915861
Name:PEREZ TIJERINA, ROSA Y
Entity type:Individual
Prefix:DR
First Name:ROSA
Middle Name:Y
Last Name:PEREZ TIJERINA
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:PO BOX 1942
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-1942
Mailing Address - Country:US
Mailing Address - Phone:787-245-6249
Mailing Address - Fax:
Practice Address - Street 1:CALLE TURABO 705
Practice Address - Street 2:URB. QUINTAS DE MONTE RIO
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-245-6249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-15
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR023281208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice