Provider Demographics
NPI:1811870207
Name:SANTIAGO CORDERO, JUAN LUIS (PHARMD)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:LUIS
Last Name:SANTIAGO CORDERO
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 1:393 VILLA BORINQUEN
Mailing Address - Street 2:
Mailing Address - City:LARES
Mailing Address - State:PR
Mailing Address - Zip Code:00669-2807
Mailing Address - Country:US
Mailing Address - Phone:939-380-4141
Mailing Address - Fax:
Practice Address - Street 1:CALLE PUBLICA & PR-2
Practice Address - Street 2:
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693
Practice Address - Country:US
Practice Address - Phone:787-855-3044
Practice Address - Fax:787-855-3044
Is Sole Proprietor?:No
Enumeration Date:2025-07-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL43249183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist