Provider Demographics
NPI:1447545272
Name:LA SANTA, GABRIEL (PHARMD)
Entity type:Individual
Prefix:
First Name:GABRIEL
Middle Name:
Last Name:LA SANTA
Suffix:
Gender:M
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:I-15 GUARIONEX VILLAS DE CANEY
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-3524
Mailing Address - Country:US
Mailing Address - Phone:787-283-3545
Mailing Address - Fax:
Practice Address - Street 1:I15 CALLE GUARIONEX
Practice Address - Street 2:
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976-3524
Practice Address - Country:US
Practice Address - Phone:787-283-3545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5297183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist