Provider Demographics
NPI:1841331121
Name:PEREZ, MABEL (PHARMACY TECHNICIAN)
Entity type:Individual
Prefix:
First Name:MABEL
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 2 BOX 6501
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-9616
Mailing Address - Country:US
Mailing Address - Phone:787-884-7447
Mailing Address - Fax:
Practice Address - Street 1:BO CAMPAMENTO 500 CAM 149
Practice Address - Street 2:SUITE 01
Practice Address - City:CIALES
Practice Address - State:PR
Practice Address - Zip Code:00638-9661
Practice Address - Country:US
Practice Address - Phone:787-871-3105
Practice Address - Fax:787-871-3122
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6046183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician