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General NPI Number Information
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NPI Number | 1992377915
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Entity Type | Individual
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Provider Name | VICTOR M SANTIAGO JR. PHARM. D.
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Gender | Male
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Dates
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Enumeration Date | 07/12/2021
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Last Update Date | 07/12/2021
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Provider Practice Location Address
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Address Line | 11000 PEMBROKE RD
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City | MIRAMAR
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State | FL
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Zip | 33025-1704
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Country | US
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Telephone | 954-441-7918
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Fax |
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Provider Business Mailing Address
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Address Line | 12755 NW 4TH AVE
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City | NORTH MIAMI
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State | FL
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Zip | 33168-3714
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Country | US
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Telephone | 305-970-7076
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS62489
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License Number State | FL
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