Provider Demographics
NPI:1346827649
Name:PEREZ, PAULA GASKIN (RPH)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:GASKIN
Last Name:PEREZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:MICHELE
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:807 HAWKSBILL ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:SATELLITE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-3850
Mailing Address - Country:US
Mailing Address - Phone:678-772-9124
Mailing Address - Fax:
Practice Address - Street 1:807 HAWKSBILL ISLAND DR
Practice Address - Street 2:
Practice Address - City:SATELLITE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-3850
Practice Address - Country:US
Practice Address - Phone:678-772-9124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-24
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0022841183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist