Provider Demographics
NPI:1316333206
Name:PEREZ, MARIA DE LOURDES (RPH)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:DE LOURDES
Last Name:PEREZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE LIRIO 32
Mailing Address - Street 2:URB ESTANCIAS DE LA FUENTE
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953
Mailing Address - Country:US
Mailing Address - Phone:787-457-1469
Mailing Address - Fax:
Practice Address - Street 1:32 CALLE LIRIO
Practice Address - Street 2:FUENTES DEL CONDADO
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953-3682
Practice Address - Country:US
Practice Address - Phone:787-457-1469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-08
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR42631835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist