Provider Demographics
NPI:1699911479
Name:PACHECO-VELIZ, XIMENA SUSANA (RPH)
Entity type:Individual
Prefix:
First Name:XIMENA
Middle Name:SUSANA
Last Name:PACHECO-VELIZ
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 1:2601 SOUTH MILITARY TRAIL
Mailing Address - Street 2:SUITE 25
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-7510
Mailing Address - Country:US
Mailing Address - Phone:561-660-7869
Mailing Address - Fax:561-660-7879
Practice Address - Street 1:2601 S MILITARY TRL STE 25
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-7512
Practice Address - Country:US
Practice Address - Phone:561-660-7869
Practice Address - Fax:561-660-7879
Is Sole Proprietor?:No
Enumeration Date:2008-12-27
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS39618183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist