Provider Demographics
NPI:1295492510
Name:PACHECO RODRIGUEZ, MARILYZ (PHARMD)
Entity type:Individual
Prefix:
First Name:MARILYZ
Middle Name:
Last Name:PACHECO RODRIGUEZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 CARR 844 APT 69
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-9575
Mailing Address - Country:US
Mailing Address - Phone:787-300-1478
Mailing Address - Fax:
Practice Address - Street 1:CARR. 863 KM. 2 BO. PAJAROS
Practice Address - Street 2:
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-780-2054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6924183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist