Provider Demographics
NPI:1457728149
Name:PEREZ, KRISTY (PHARM D)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8804 NW 112TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-4531
Mailing Address - Country:US
Mailing Address - Phone:786-202-7580
Mailing Address - Fax:
Practice Address - Street 1:8804 NW 112TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-4531
Practice Address - Country:US
Practice Address - Phone:786-202-7580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-28
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS54068183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist