Provider Demographics
NPI:1154618817
Name:SANTANA, MERAIZA (TECNICO)
Entity type:Individual
Prefix:
First Name:MERAIZA
Middle Name:
Last Name:SANTANA
Suffix:
Gender:F
Credentials:TECNICO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4210 CARR 693 MAHI MAHI SHOPPING VILLAGE
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646
Mailing Address - Country:US
Mailing Address - Phone:787-278-5811
Mailing Address - Fax:
Practice Address - Street 1:4210 CARR 693 MAHI MAHI SHOPPING VILLAGE
Practice Address - Street 2:
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646
Practice Address - Country:US
Practice Address - Phone:787-278-5811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7212183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician