Provider Demographics
NPI:1811535677
Name:SANTANA QUINONES, AITZA I (PHARMD)
Entity type:Individual
Prefix:
First Name:AITZA
Middle Name:I
Last Name:SANTANA QUINONES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:AITZA
Other - Middle Name:I
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:134 CALLE PARAGUAY
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00917-1766
Mailing Address - Country:US
Mailing Address - Phone:787-462-2084
Mailing Address - Fax:
Practice Address - Street 1:134 CALLE PARAGUAY
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-1766
Practice Address - Country:US
Practice Address - Phone:787-462-2084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-11
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6485183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist