Provider Demographics
NPI:1447385745
Name:SANTOS HERNANDEZ, CARMEN SONIA (R PH)
Entity Type:Individual
Prefix:MRS
First Name:CARMEN SONIA
Middle Name:
Last Name:SANTOS HERNANDEZ
Suffix:
Gender:F
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PMB DEPT. 260
Mailing Address - Street 2:HC01 BOX 29030
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-8900
Mailing Address - Country:US
Mailing Address - Phone:787-405-1026
Mailing Address - Fax:
Practice Address - Street 1:CARR 179 KM. 0.3
Practice Address - Street 2:
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784
Practice Address - Country:US
Practice Address - Phone:186-683-0208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19051835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1905OtherR PH