Provider Demographics
NPI:1093358871
Name:SANTIAGO LEON, LOUIS FELIPE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:FELIPE
Last Name:SANTIAGO LEON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 CALLE SAN JOSE APT 1101
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-4767
Mailing Address - Country:US
Mailing Address - Phone:787-421-5168
Mailing Address - Fax:
Practice Address - Street 1:100 GRAND PASEO BLVD
Practice Address - Street 2:
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00926-5905
Practice Address - Country:US
Practice Address - Phone:787-283-2555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-23
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist