Provider Demographics
NPI:1801135579
Name:PEREZ, SANDRA M (PHARMD RPH)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:M
Last Name:PEREZ
Suffix:
Gender:F
Credentials:PHARMD RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ST. A 35 BAHIA
Mailing Address - Street 2:
Mailing Address - City:GUANICA
Mailing Address - State:PR
Mailing Address - Zip Code:00653
Mailing Address - Country:US
Mailing Address - Phone:787-821-2361
Mailing Address - Fax:
Practice Address - Street 1:601 YAUCO PLAZA II
Practice Address - Street 2:
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-4448
Practice Address - Country:US
Practice Address - Phone:787-267-6610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-31
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4751183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist