MEDICARE: DR. JOSE JUAN DORESTE SANTIAGO DNP, CRNA

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	367500000X	Certified Registered Nurse Anesthetist	134749	PR
2	367500000X	Certified Registered Nurse Anesthetist	11044473	FL

General Provider Information

NPI Number	:	1356929046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE JUAN DORESTE SANTIAGO DNP, CRNA

Provider Business Mailing Address
First Line	:	927 SECT PITILLO
Second Line	:
City	:	MAYAGUEZ
State	:	PR
Zip	:	00682-7315
Country	:	US
Telephone Number	:	787-233-9514
Fax Number	:

Provider Business Practice Location Address
First Line	:	PASEO LOS ROBLES EDIF LA CIMA APT 204-B
Second Line	:
City	:	MAYAGUEZ
State	:	PR
Zip	:	00680
Country	:	US
Telephone Number	:	787-233-9514
Fax Number	:

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

Provider Enumeration Date	:	04/01/2021
Last Update Date	:	06/19/2026

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