Provider Demographics
NPI:1750774261
Name:PEREZ REYES, VEVA
Entity type:Individual
Prefix:
First Name:VEVA
Middle Name:
Last Name:PEREZ REYES
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 8 BOX 50401
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-6105
Mailing Address - Country:US
Mailing Address - Phone:787-585-7712
Mailing Address - Fax:
Practice Address - Street 1:HC 8 BOX 50401
Practice Address - Street 2:
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659-6105
Practice Address - Country:US
Practice Address - Phone:787-585-7712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-07
Last Update Date:2015-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6292183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist