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General NPI Number Information
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NPI Number | 1720713167
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Entity Type | Individual
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Provider Name | IDALIZ PEREZ-SANTIAGO PHARMACY TECHNITIAN
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Gender | Female
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Dates
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Enumeration Date | 07/20/2022
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Last Update Date | 07/20/2022
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Provider Practice Location Address
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Address Line | BARRIO LOMAS GARCIA CARR. 165 KM. 0.2
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City | NARANJITO
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State | PR
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Zip | 00719
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Country | US
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Telephone | 787-245-9379
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Fax |
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Provider Business Mailing Address
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Address Line | HC 71 BOX 2479
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City | NARANJITO
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State | PR
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Zip | 00719-9754
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Country | US
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Telephone | 787-245-9379
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 012263
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License Number State | PR
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