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NPI Code Detail

MEDICARE: DR. JORGE ALEXANDER SANTIAGO PHARMD

MEDICARE: DR. JORGE ALEXANDER SANTIAGO PHARMD
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
1183500000XPharmacistPS61546FL

General Provider Information

NPI Number : 1497360267
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JORGE ALEXANDER SANTIAGO PHARMD
Provider Business Mailing Address
First Line : 4538 BIRDSONG BLVD
Second Line :
City : LUTZ
State : FL
Zip : 33559-6295
Country : US
Telephone Number : 786-251-4224
Fax Number :
Provider Business Practice Location Address
First Line : 1704 W HILLSBOROUGH AVE
Second Line :
City : TAMPA
State : FL
Zip : 33603-1131
Country : US
Telephone Number : 813-872-6733
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2020
Last Update Date : 09/09/2020

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