Healthcare Provider Details

I. General information

NPI: 1750487039
Provider Name (Legal Business Name): SONIA IVETTE SANTIAGO PHARMACIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 CALLE PEDRO ARROYO
OROCOVIS PR
00720-4422
US

IV. Provider business mailing address

PO BOX 152
OROCOVIS PR
00720-0152
US

V. Phone/Fax

Practice location:
  • Phone: 787-867-2820
  • Fax: 787-867-2820
Mailing address:
  • Phone: 787-867-3976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number003854
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: