Healthcare Provider Details

I. General information

NPI: 1477536852
Provider Name (Legal Business Name): FARMACIA SAN MARTIN MANAT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PLAZA PUERTA DEL SOL #54, CARR #2, SUITE #3,
MANAT PR
00674-4973
US

IV. Provider business mailing address

ESTANCIAS DE MANATI II # 153 CALLE DORADO
MANATI PR
00674
US

V. Phone/Fax

Practice location:
  • Phone: 787-884-4445
  • Fax: 787-884-4444
Mailing address:
  • Phone: 787-854-7265
  • Fax: 787-854-7265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number3920
License Number StatePR

VIII. Authorized Official

Name: MS. MILDRED N SANTIAGO
Title or Position: CEO
Credential:
Phone: 787-884-4444