MEDICARE: JOHANN SANTOS-RODRIGUEZ DC

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	111N00000X	Chiropractor	1030	PR

General Provider Information

NPI Number	:	1558218255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHANN SANTOS-RODRIGUEZ DC

Provider Business Mailing Address
First Line	:	400 AVE DOMENECH STE 303
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00918-3703
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 AVE DOMENECH STE 303
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00918-3703
Country	:	US
Telephone Number	:	939-281-2424
Fax Number	:

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

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/12/2026

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