Provider Demographics
NPI:1346524402
Name:SANTIAGO-RIVERA, ARACELIS (PHA)
Entity Type:Individual
Prefix:MISS
First Name:ARACELIS
Middle Name:
Last Name:SANTIAGO-RIVERA
Suffix:
Gender:F
Credentials:PHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 4055
Mailing Address - Street 2:CFSE AVE. MIRAMAR CARR #2 BO. OBRERO
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-4055
Mailing Address - Country:US
Mailing Address - Phone:787-878-5757
Mailing Address - Fax:787-880-6537
Practice Address - Street 1:CFSE AVE. MIRAMAR CARR #2 BO. OBRERO
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00614-4055
Practice Address - Country:US
Practice Address - Phone:787-878-5757
Practice Address - Fax:787-880-6537
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4492333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy