Healthcare Provider Details

I. General information

NPI: 1881545762
Provider Name (Legal Business Name): LEIDY WYNNE PEREZ RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2026
Last Update Date: 02/05/2026
Certification Date: 02/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11545 E APACHE TRL
APACHE JUNCTION AZ
85120-3522
US

IV. Provider business mailing address

11545 E APACHE TRL
APACHE JUNCTION AZ
85120-3522
US

V. Phone/Fax

Practice location:
  • Phone: 480-986-1387
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS027855
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: