Provider Demographics
NPI:1609925379
Name:PEREZ, JUDITH (RPH)
Entity Type:Individual
Prefix:
First Name:JUDITH
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 1:4M36 CALLE OLIVA
Mailing Address - Street 2:URB LOMAS VERDES
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956-2960
Mailing Address - Country:US
Mailing Address - Phone:787-798-2790
Mailing Address - Fax:787-798-2790
Practice Address - Street 1:349 CALLE MENDEZ VIGO
Practice Address - Street 2:SUITE 10
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-4917
Practice Address - Country:US
Practice Address - Phone:787-278-1576
Practice Address - Fax:787-278-0936
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4032183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist