Healthcare Provider Details

I. General information

NPI: 1174436158
Provider Name (Legal Business Name): ELSA MARIA PEREZ RUIZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

927 CALLE DURBEC
SAN JUAN PR
00924-3344
US

IV. Provider business mailing address

16008 WADKINS DR
CANOVANAS PR
00729-4541
US

V. Phone/Fax

Practice location:
  • Phone: 787-769-5350
  • Fax:
Mailing address:
  • Phone: 787-206-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number002946
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: