Provider Demographics
NPI:1306567557
Name:PEREZ COLLADO, DENNIS YAMIL (PHARMD)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:YAMIL
Last Name:PEREZ COLLADO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14651 WESTBROOK CIR APT 314
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34211-2353
Mailing Address - Country:US
Mailing Address - Phone:941-704-1535
Mailing Address - Fax:
Practice Address - Street 1:14651 WESTBROOK CIR APT 314
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34211-2353
Practice Address - Country:US
Practice Address - Phone:941-704-1535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS64822333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy