Provider Demographics
NPI:1023119963
Name:PERGUZ INC
Entity type:Organization
Organization Name:PERGUZ INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:GUZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-703-1337
Mailing Address - Street 1:3B4 CALLE BORGONA
Mailing Address - Street 2:URB. VILLA DEL REY 3RA SECCION
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727
Mailing Address - Country:US
Mailing Address - Phone:787-703-1337
Mailing Address - Fax:787-703-1337
Practice Address - Street 1:3B4 CALLE BORGONA
Practice Address - Street 2:URB. VILLA DEL REY 3RA SECCION
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727
Practice Address - Country:US
Practice Address - Phone:787-703-1337
Practice Address - Fax:787-703-1337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center