Provider Demographics
NPI:1376764738
Name:SANTIAGO, WILLIAM (PHARM D, RPH)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:SANTIAGO
Suffix:
Gender:M
Credentials:PHARM D, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 BERRY TREE PL
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33510-4314
Mailing Address - Country:US
Mailing Address - Phone:215-356-7948
Mailing Address - Fax:
Practice Address - Street 1:216 BERRY TREE PL
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33510-4314
Practice Address - Country:US
Practice Address - Phone:215-356-7948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP441122183500000X
FLPS46023183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist