Individual provider Active NPI

Minerva De Santiago, BSPH

  • Pharmacist
  • Mayaguez, PR
National Provider Identifier
1750420139
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2555 Issued in PR
Practice address
1050 Ave Los Corazones
Suite 103
Mayaguez, PR 00680-7042
Phone
(787) 831-0600
Fax
(787) 265-0670
NPI assigned
Feb 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2555 PR Primary

Addresses

Primary practice location

1050 Ave Los Corazones
Suite 103
Mayaguez, PR 00680-7042

Mailing address

1050 Ave Los Corazones
Suite 103
Mayaguez, PR 00680-7042
Phone (787) 831-0600

Other identifiers 1

IdentifierTypeStateIssuer
4018873OtherPRNABP

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

LicenseStateTypeSpecialty
2555PRMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Farmacia Centro Renal Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750420139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 AVE LOS CORAZONES",
            "address_2": "SUITE 103",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006807042",
            "telephone_number": "787-831-0600",
            "fax_number": "787-265-0670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 AVE LOS CORAZONES",
            "address_2": "SUITE 103",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006807042",
            "telephone_number": "787-831-0600",
            "fax_number": "787-265-0670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE SANTIAGO",
        "first_name": "MINERVA",
        "name_prefix": "Mrs.",
        "credential": "BSPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PR",
            "license": "2555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "4018873",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, 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.

Verify at the official NPI Registry.