Provider Demographics
NPI:1043966542
Name:PEREZ RODRIGUEZ, CASANDRA ISABEL (PHARMD)
Entity Type:Individual
Prefix:
First Name:CASANDRA
Middle Name:ISABEL
Last Name:PEREZ RODRIGUEZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE 12 A-15 REPARTO UNIVERSIDAD
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00683
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5 CALLE CARRO
Practice Address - Street 2:
Practice Address - City:SAN GERMAN
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00683
Practice Address - Country:US
Practice Address - Phone:787-892-5290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-23
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR006989183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist