MEDICARE: MS. MARITZA E PEREZ R.PH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	28RI02649800	NJ
2	183500000X	Pharmacist	PS63111	FL

General Provider Information

NPI Number	:	1740568542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARITZA E PEREZ R.PH

Provider Business Mailing Address
First Line	:	705 INGRAHAM AVE
Second Line	:
City	:	HAINES CITY
State	:	FL
Zip	:	33844-4327
Country	:	US
Telephone Number	:	863-291-3314
Fax Number	:	863-659-4419

Provider Business Practice Location Address
First Line	:	705 INGRAHAM AVE
Second Line	:
City	:	HAINES CITY
State	:	FL
Zip	:	33844-4327
Country	:	US
Telephone Number	:	863-291-3314
Fax Number	:	863-659-4419

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2011
Last Update Date	:	10/30/2025

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