Provider Demographics
NPI:1477674612
Name:PEREZ, YAMELISE (PHARMACY TECHNITIAN)
Entity Type:Individual
Prefix:
First Name:YAMELISE
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:PHARMACY TECHNITIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CASA A-32 EXT VISTA DE CAMUY
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-2938
Mailing Address - Country:US
Mailing Address - Phone:787-383-3487
Mailing Address - Fax:
Practice Address - Street 1:CALLE D BZN 79 SANTA ROSA
Practice Address - Street 2:
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659
Practice Address - Country:US
Practice Address - Phone:787-383-3487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5545183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician