Provider Demographics
NPI:1558971200
Name:BRIGNONI PEREZ, INGRID (PHARMD)
Entity Type:Individual
Prefix:
First Name:INGRID
Middle Name:
Last Name:BRIGNONI PEREZ
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 1:2931 PAISAJE ST. VILLA PANONIA
Mailing Address - Street 2:APT 205
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716
Mailing Address - Country:US
Mailing Address - Phone:787-310-0704
Mailing Address - Fax:
Practice Address - Street 1:BO PLAYA CARR 401 KM 0.9
Practice Address - Street 2:FARMACIA TRES HERMANOS
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610
Practice Address - Country:US
Practice Address - Phone:787-826-6453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-07
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6776183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist