Provider Demographics
NPI:1861707002
Name:PEREZ-ALAMEDA, DAIZA MARIE
Entity type:Individual
Prefix:
First Name:DAIZA
Middle Name:MARIE
Last Name:PEREZ-ALAMEDA
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:CARR. 368, KM.11.2
Mailing Address - Street 2:BO. SUSUA ALTA SECTOR LA PALMITA
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-1793
Mailing Address - Country:US
Mailing Address - Phone:787-901-7254
Mailing Address - Fax:
Practice Address - Street 1:351 AVE HOSTOS
Practice Address - Street 2:MEDICAL EMPORIUM II SUITE A31
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-1502
Practice Address - Country:US
Practice Address - Phone:787-901-7254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-12
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR907235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist