Provider Demographics
NPI:1306544911
Name:PEREZ AYALA, NICOLLE YARIE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NICOLLE
Middle Name:YARIE
Last Name:PEREZ AYALA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB BRISAS DEL CAMPANERO II 293 CALLE AQUAMARINA E10
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949
Mailing Address - Country:US
Mailing Address - Phone:939-579-9026
Mailing Address - Fax:
Practice Address - Street 1:URBANIZACION BRISAS DEL CAMPANERO 2 293 CALLE 7 E10
Practice Address - Street 2:
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-4871
Practice Address - Country:US
Practice Address - Phone:797-786-6306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7077183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist