Individual provider Active NPI

Ivette Maria Santiago, RPH

  • Pharmacist
  • Toa Baja, PR
National Provider Identifier
1235617838
Registry record updated Aug 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
3526 Issued in PR
Practice address
HF16 Calle Lizzie Graham
Toa Baja, PR 00949-3634
Phone
(787) 795-2935
Fax
(787) 200-2839
NPI assigned
Aug 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 3526 PR Primary

Addresses

Primary practice location

HF16 Calle Lizzie Graham
Toa Baja, PR 00949-3634

Mailing address

PO Box 51513
Toa Baja, PR 00950-1513
Phone (787) 795-2935

Other identifiers 1

IdentifierTypeStateIssuer
051168OtherPRPR BOARD OF PHARMACY

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
3526PRMDPharmacy Technician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1533513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533513600000",
    "number": "1235617838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51513",
            "city": "TOA BAJA",
            "state": "PR",
            "postal_code": "009501513",
            "telephone_number": "787-795-2935",
            "fax_number": "787-200-2839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HF16 CALLE LIZZIE GRAHAM",
            "city": "TOA BAJA",
            "state": "PR",
            "postal_code": "009493634",
            "telephone_number": "787-795-2935",
            "fax_number": "787-200-2839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "IVETTE",
        "middle_name": "MARIA",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-06",
        "last_updated": "2018-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PR",
            "license": "3526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PR BOARD OF PHARMACY",
            "identifier": "051168",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toa Baja, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.