Provider Demographics
NPI:1669144697
Name:PEREZ, JASMIN M (PHARMACY TECHNICIAN)
Entity type:Individual
Prefix:
First Name:JASMIN
Middle Name:M
Last Name:PEREZ
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
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Mailing Address - Street 1:11433 PLAINS HWY
Mailing Address - Street 2:
Mailing Address - City:EATON RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:48827-9747
Mailing Address - Country:US
Mailing Address - Phone:517-528-6927
Mailing Address - Fax:
Practice Address - Street 1:715 S MAIN ST
Practice Address - Street 2:
Practice Address - City:EATON RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:48827-1427
Practice Address - Country:US
Practice Address - Phone:517-663-8430
Practice Address - Fax:517-663-8441
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5303038362202C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202C00000XAllopathic & Osteopathic PhysiciansIndependent Medical Examiner