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NPI Code Detail

MEDICARE: DR. JUAN SANTOS-OLIVARES RPH, PHARM D

MEDICARE: DR. JUAN SANTOS-OLIVARES RPH, PHARM D
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
1183500000XPharmacist4030PR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10417OTHERPRVACCINE PROVIDER
24030OTHERPRSTATE LICENSE

General Provider Information

NPI Number : 1831174630
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUAN SANTOS-OLIVARES RPH, PHARM D
Provider Business Mailing Address
First Line : A18 CALLE PALMA REAL
Second Line : VILLAS DEL SAGRADO CORAZON
City : PONCE
State : PR
Zip : 00716
Country : US
Telephone Number : 787-647-0590
Fax Number : 787-841-5551
Provider Business Practice Location Address
First Line : 553 CALLE RAMOS ANTONINI
Second Line : EL TUQUE
City : PONCE
State : PR
Zip : 00728-4806
Country : US
Telephone Number : 787-844-2805
Fax Number : 787-841-5551
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2005
Last Update Date : 05/17/2021

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