Provider Demographics
NPI:1215322474
Name:NAZARIO-SANTALIZ, VILMA MAGDIEL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:VILMA
Middle Name:MAGDIEL
Last Name:NAZARIO-SANTALIZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:MAGDIEL
Other - Middle Name:
Other - Last Name:NAZARIO-SANTALIZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:975 AVE HOSTOS STE 2100
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680
Mailing Address - Country:US
Mailing Address - Phone:787-265-1090
Mailing Address - Fax:787-265-1074
Practice Address - Street 1:975 AVE HOSTOS STE 2100
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-265-1090
Practice Address - Fax:787-265-1074
Is Sole Proprietor?:No
Enumeration Date:2015-04-03
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6265183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist