Provider Demographics
NPI:1285974121
Name:GARRASTAZU-SANTIAGO, YANIRA MICHELLE (PHARMD)
Entity type:Individual
Prefix:
First Name:YANIRA
Middle Name:MICHELLE
Last Name:GARRASTAZU-SANTIAGO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URBANIZACION FUENTEBELLA
Mailing Address - Street 2:1617 CALLE TORINO
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953
Mailing Address - Country:US
Mailing Address - Phone:787-549-1455
Mailing Address - Fax:
Practice Address - Street 1:URB FUENTEBELLA
Practice Address - Street 2:1617 CALLE TORINO
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953-3707
Practice Address - Country:US
Practice Address - Phone:787-549-1455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-28
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5131183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist