MEDICARE: DR. MICHELALDEMAR SANTIAGO-SANCHEZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	17218	PR

General Provider Information

NPI Number	:	1124297437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELALDEMAR SANTIAGO-SANCHEZ M.D.

Provider Business Mailing Address
First Line	:	PO BOX 71325
Second Line	:	SUITE 64
City	:	SAN JUAN
State	:	PR
Zip	:	00936-8425
Country	:	US
Telephone Number	:	787-282-2525
Fax Number	:

Provider Business Practice Location Address
First Line	:	892 CALLE 45 SE
Second Line	:	REPARTO METROPOLITANO
City	:	SAN JUAN
State	:	PR
Zip	:	00921-1815
Country	:	US
Telephone Number	:	787-282-2525
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2008
Last Update Date	:	02/13/2014

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