Provider Demographics
NPI:1093508780
Name:FERNANDEZ MARTINEZ, HAYLISSE MARIE (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:HAYLISSE
Middle Name:MARIE
Last Name:FERNANDEZ MARTINEZ
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 597
Mailing Address - Street 2:
Mailing Address - City:SABANA HOYOS
Mailing Address - State:PR
Mailing Address - Zip Code:00688-0597
Mailing Address - Country:US
Mailing Address - Phone:787-321-8643
Mailing Address - Fax:
Practice Address - Street 1:2135 CARR 2 STE 1
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-5222
Practice Address - Country:US
Practice Address - Phone:787-785-9176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR008433183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist