Provider Demographics
NPI:1104522887
Name:PEREZ SOTO, LUIGGI (PHARMD)
Entity type:Individual
Prefix:
First Name:LUIGGI
Middle Name:
Last Name:PEREZ SOTO
Suffix:
Gender:M
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:PO BOX 3005
Mailing Address - Street 2:HATO ARRIBA STATION
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685
Mailing Address - Country:US
Mailing Address - Phone:787-877-3432
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 111 KM 14.5
Practice Address - Street 2:BARRIO HATO ARRIBA
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685
Practice Address - Country:US
Practice Address - Phone:787-896-6340
Practice Address - Fax:787-896-3036
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-03
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR008052183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR008052OtherPUERTO RICO PHARMACY BOARD