Provider Demographics
NPI:1457555617
Name:SANTOS, JAVIER (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JAVIER
Middle Name:
Last Name:SANTOS
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12229 SW 16TH TER # I-108
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-1579
Mailing Address - Country:US
Mailing Address - Phone:305-559-8194
Mailing Address - Fax:
Practice Address - Street 1:998 SW 67TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4761
Practice Address - Country:US
Practice Address - Phone:305-261-3602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL16555183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist