Healthcare Provider Details
I. General information
NPI: 1104469717
Provider Name (Legal Business Name): DAISY R PEREZ LABOY PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/26/2019
Last Update Date: 10/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
500 CARR 1 URB ALTOS DE LA FUENTE
CAGUAS PR
00727
US
IV. Provider business mailing address
PO BOX 334522
PONCE PR
00733-4522
US
V. Phone/Fax
- Phone: 787-286-8242
- Fax: 787-286-8249
- Phone: 787-974-5183
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 006709 |
| License Number State | PR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: