Provider Demographics
NPI:1093935165
Name:PEREZ, DAISY (RPH)
Entity Type:Individual
Prefix:
First Name:DAISY
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARR 2 INTER CALLE BARAMAYA
Mailing Address - Street 2:2643 PONCE BY PASS
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728
Mailing Address - Country:US
Mailing Address - Phone:787-812-1616
Mailing Address - Fax:787-812-1625
Practice Address - Street 1:CARR 2 INTER CALLE BARAMAYA
Practice Address - Street 2:2643 PONCE BY PASS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728
Practice Address - Country:US
Practice Address - Phone:787-812-1616
Practice Address - Fax:787-812-1625
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4319183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist