Healthcare Provider Details

I. General information

NPI: 1639908452
Provider Name (Legal Business Name): CAROL MEJIA PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2024
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 191227
SAN JUAN PR
00919-1227
US

IV. Provider business mailing address

381 CALLE BUENAVENTURA
SAN JUAN PR
00915-2325
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number8258
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: