Provider Demographics
NPI:1598301814
Name:SANTIAGO TRISTANI, DAYANA MARIE
Entity Type:Individual
Prefix:
First Name:DAYANA
Middle Name:MARIE
Last Name:SANTIAGO TRISTANI
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 1:150 CARR 857
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-2277
Mailing Address - Country:US
Mailing Address - Phone:787-701-0808
Mailing Address - Fax:
Practice Address - Street 1:150 CARR 857
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987-2277
Practice Address - Country:US
Practice Address - Phone:787-701-0808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-21
Last Update Date:2022-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR006707183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist