Provider Demographics
NPI:1912793779
Name:MENDEZ SANTOS, MARIELA (PHARMD)
Entity type:Individual
Prefix:
First Name:MARIELA
Middle Name:
Last Name:MENDEZ SANTOS
Suffix:
Gender:
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:PO BOX 548
Mailing Address - Street 2:
Mailing Address - City:AGUAS BUENAS
Mailing Address - State:PR
Mailing Address - Zip Code:00703-0548
Mailing Address - Country:US
Mailing Address - Phone:939-630-3272
Mailing Address - Fax:
Practice Address - Street 1:BO MULAS CARR 174 KM 21.1
Practice Address - Street 2:
Practice Address - City:AGUAS BUENAS
Practice Address - State:PR
Practice Address - Zip Code:00703
Practice Address - Country:US
Practice Address - Phone:787-732-7900
Practice Address - Fax:787-732-6658
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6899183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist