Provider Demographics
NPI:1528270535
Name:DE LA TORRE, SANTA ANTONIA (RPH)
Entity type:Individual
Prefix:MRS
First Name:SANTA
Middle Name:ANTONIA
Last Name:DE LA TORRE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 567
Mailing Address - Street 2:
Mailing Address - City:BOQUERON
Mailing Address - State:PR
Mailing Address - Zip Code:00622-0567
Mailing Address - Country:US
Mailing Address - Phone:787-851-2025
Mailing Address - Fax:787-254-0235
Practice Address - Street 1:108 CALLE MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623-4060
Practice Address - Country:US
Practice Address - Phone:787-851-2025
Practice Address - Fax:787-254-0235
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2117183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist