Provider Demographics
NPI:1386268340
Name:PEREZ, ROSA IRIS (PHARMACY TECHNITIAN)
Entity type:Individual
Prefix:MISS
First Name:ROSA
Middle Name:IRIS
Last Name:PEREZ
Suffix:
Gender:F
Credentials:PHARMACY TECHNITIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BO BUEN CONSEJO
Mailing Address - Street 2:211 SAN RAFAEL
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-1609
Mailing Address - Country:US
Mailing Address - Phone:787-349-5262
Mailing Address - Fax:
Practice Address - Street 1:BO BUEN CONSEJO
Practice Address - Street 2:211 SAN RAFAEL
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-1609
Practice Address - Country:US
Practice Address - Phone:787-349-5262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-04
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2502183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician