Provider Demographics
NPI:1417238064
Name:PEREZ, MARIA LUISA (REGISTEREDPHARMACIST)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:LUISA
Last Name:PEREZ
Suffix:
Gender:F
Credentials:REGISTEREDPHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:867 Q SANTANDER STREET
Mailing Address - Street 2:VISTAMAR
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00983-0000
Mailing Address - Country:US
Mailing Address - Phone:787-604-8352
Mailing Address - Fax:
Practice Address - Street 1:867 Q SANTANDER STREET VIISTAMAR
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983-0000
Practice Address - Country:US
Practice Address - Phone:787-604-8352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3947183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist