Provider Demographics
NPI:1306476338
Name:VALLEJO PEREZ, YANELIS
Entity type:Individual
Prefix:MRS
First Name:YANELIS
Middle Name:
Last Name:VALLEJO PEREZ
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:AVE. LAS CUMBRES CARR. 199 KM 1.2
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-708-6545
Mailing Address - Fax:787-544-3069
Practice Address - Street 1:AVE. LAS CUMBRES CARR. 199 KM. 1.2
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-708-6545
Practice Address - Fax:787-544-3069
Is Sole Proprietor?:No
Enumeration Date:2020-01-17
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8964183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician