Provider Demographics
NPI:1093481731
Name:SANTOS MENDEZ, VALERIA MARIA
Entity Type:Individual
Prefix:
First Name:VALERIA
Middle Name:MARIA
Last Name:SANTOS MENDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:A18 CALLE PALMA REAL
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-2548
Mailing Address - Country:US
Mailing Address - Phone:787-354-8355
Mailing Address - Fax:
Practice Address - Street 1:A18 CALLE PALMA REAL
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-2548
Practice Address - Country:US
Practice Address - Phone:787-354-8355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-22
Last Update Date:2021-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL39478390200000X
PR02640390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR02640OtherPHARMACY INTERN