Provider Demographics
NPI:1003101254
Name:SANTIAGO, AUREA E (RPH)
Entity Type:Individual
Prefix:
First Name:AUREA
Middle Name:E
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COND. ATRIUM PARK 17 C CALLE REGINA MEDINA
Mailing Address - Street 2:APARTAMENTO A303
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-529-1821
Mailing Address - Fax:787-287-0558
Practice Address - Street 1:COND ATRIUM PARK # A303
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-6001
Practice Address - Country:US
Practice Address - Phone:787-529-1821
Practice Address - Fax:787-287-0558
Is Sole Proprietor?:No
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3809183500000X
NJ28RI02878300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist