Active NPI
Kiara Melissa Santiago Fidalgo
- Pharmacist
- Juncos, PR
National Provider Identifier
1053885897
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 006634
- Practice address
- Carr 31 KM 24.0
Juncos, PR 00777 - Phone
- (787) 713-1425
- NPI assigned
- Jan 15, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 006634 | PR | Primary |
Addresses
Primary practice location
Carr 31 KM 24.0
Juncos, PR 00777
Mailing address
77 Cautiva Almacigos
Hacienda San Jose
Caguas, PR 00727
Phone (787) 222-9926
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5031801 | Medicaid | PR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006634 | PR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547510400000",
"number": "1053885897",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "77 CAUTIVA ALMACIGOS",
"address_2": "HACIENDA SAN JOSE",
"city": "CAGUAS",
"state": "PR",
"postal_code": "00727",
"telephone_number": "787-222-9926"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CARR 31 KM 24.0",
"city": "JUNCOS",
"state": "PR",
"postal_code": "00777",
"telephone_number": "787-713-1425"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTIAGO FIDALGO",
"first_name": "KIARA",
"middle_name": "MELISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-15",
"last_updated": "2019-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PR",
"license": "006634",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5031801",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Juncos, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.