Provider Demographics
NPI:1578380929
Name:GRAXIRENA SANTANA, DALIA M (RPH)
Entity type:Individual
Prefix:
First Name:DALIA
Middle Name:M
Last Name:GRAXIRENA SANTANA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1646
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00745-1646
Mailing Address - Country:US
Mailing Address - Phone:787-888-1888
Mailing Address - Fax:787-888-8886
Practice Address - Street 1:PO BOX 1646
Practice Address - Street 2:
Practice Address - City:RIO GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00745-1646
Practice Address - Country:US
Practice Address - Phone:787-888-1888
Practice Address - Fax:787-888-8886
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR001986183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist