Provider Demographics
NPI:1265538565
Name:SANTANA, ANA IRIS (PHTCH)
Entity type:Individual
Prefix:MRS
First Name:ANA
Middle Name:IRIS
Last Name:SANTANA
Suffix:
Gender:F
Credentials:PHTCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE 4D 162
Mailing Address - Street 2:URB. ALTURAS DE RIO GRANDE
Mailing Address - City:RIO GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00745
Mailing Address - Country:US
Mailing Address - Phone:787-888-5471
Mailing Address - Fax:
Practice Address - Street 1:CARR 3 KM 28.8
Practice Address - Street 2:
Practice Address - City:RIO GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00745
Practice Address - Country:US
Practice Address - Phone:787-887-2602
Practice Address - Fax:787-809-8398
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3605183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR3605OtherPHARMACY TECH. LICENSE