Provider Demographics
NPI:1649788100
Name:PEREZ PIZARRO, EUNICE
Entity type:Individual
Prefix:
First Name:EUNICE
Middle Name:
Last Name:PEREZ PIZARRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 5 BOX 7271
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00971-9589
Mailing Address - Country:US
Mailing Address - Phone:787-215-3386
Mailing Address - Fax:
Practice Address - Street 1:MARGINAL SAN ROBERTO 996
Practice Address - Street 2:PROFESSIONAL OFFICE PARK V
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00923-0000
Practice Address - Country:US
Practice Address - Phone:844-347-7806
Practice Address - Fax:787-641-0797
Is Sole Proprietor?:No
Enumeration Date:2018-01-18
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR006569183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4007623OtherDRIVER'S LICENSE