Provider Demographics
NPI:1740568542
Name:PEREZ, MARITZA E (RPH)
Entity Type:Individual
Prefix:MS
First Name:MARITZA
Middle Name:E
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 1:505 DEL PRADO BLVD N
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33909-2269
Mailing Address - Country:US
Mailing Address - Phone:239-574-8846
Mailing Address - Fax:239-574-7080
Practice Address - Street 1:505 DEL PRADO BLVD N
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909-2269
Practice Address - Country:US
Practice Address - Phone:239-574-8846
Practice Address - Fax:239-574-7080
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-27
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS35453183500000X
NJ28RI02649800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist