Provider Demographics
NPI:1982130530
Name:NOGUERAS-SANTIAGO, LUZ
Entity Type:Individual
Prefix:
First Name:LUZ
Middle Name:
Last Name:NOGUERAS-SANTIAGO
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 1:116 AVE LOS ROSALES
Mailing Address - Street 2:PARCELAS IMBERY
Mailing Address - City:BARCELONETA
Mailing Address - State:PR
Mailing Address - Zip Code:00617-3432
Mailing Address - Country:US
Mailing Address - Phone:787-510-0148
Mailing Address - Fax:
Practice Address - Street 1:116 AVE LOS ROSALES
Practice Address - Street 2:PARCELAS IMBERY
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617-3432
Practice Address - Country:US
Practice Address - Phone:787-510-0148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-02
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6359183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist