MEDICARE: MRS. MARIA I. SANTIAGO

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	163WP0808X	Psychiatric/Mental Health Registered Nurse	000146	PR

General Provider Information

NPI Number	:	1306922943
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARIA I. SANTIAGO

Provider Business Mailing Address
First Line	:	HC 3 BOX 20250
Second Line	:
City	:	LAJAS
State	:	PR
Zip	:	00667-9502
Country	:	US
Telephone Number	:	787-808-3302
Fax Number	:

Provider Business Practice Location Address
First Line	:	218 BROOK ST
Second Line	:	BLDG 21
City	:	FORT BUCHANAN
State	:	PR
Zip	:	00934-4206
Country	:	US
Telephone Number	:	787-707-2178
Fax Number	:

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

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	07/08/2007

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