Active NPI
Wanda Ivelisse Santos, RPH
- Pharmacist
- Bayamon, PR
National Provider Identifier
1285666339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 4873
- Practice address
- Farmacias Plaza 15 Ave. Los Dominicos Miraflores
Bayamon, PR 00961 - Phone
- (787) 797-7467
- Fax
- (787) 797-2650
- NPI assigned
- Jul 7, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | 4873 | PR | Primary |
Addresses
Primary practice location
Farmacias Plaza 15 Ave. Los Dominicos Miraflores
Bayamon, PR 00961
Mailing address
Urb.Mansiones de Montecasino II 599 Calle Reinita
Toa Alta, PR 00953-2256
Phone (939) 630-4916
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4873 | PR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285666339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "URB.MANSIONES DE MONTECASINO II 599 CALLE REINITA",
"city": "TOA ALTA",
"state": "PR",
"postal_code": "009532256",
"telephone_number": "939-630-4916",
"fax_number": "787-252-3757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "FARMACIAS PLAZA 15 AVE. LOS DOMINICOS MIRAFLORES",
"city": "BAYAMON",
"state": "PR",
"postal_code": "00961",
"telephone_number": "787-797-7467",
"fax_number": "787-797-2650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTOS",
"first_name": "WANDA",
"middle_name": "IVELISSE",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PR",
"license": "4873",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bayamon, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.