Individual
MRS. DIWATA M PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS PHAR
Contact information
Practice address
15170 W BELL RD STE 100, SURPRISE, AZ 85374
(702) 339-2183
Mailing address
10603 W EL CORTEZ PL, PEORIA, AZ 85383-9677
(702) 339-2183
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15915
NV
Other
Enumeration date
04/17/2007
Last updated
05/16/2018
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