Healthcare Provider Details

I. General information

NPI: 1275529778
Provider Name (Legal Business Name): JOSE RAMON SANTIAGO-TORRES M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 09/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SECTOR 4 CALLE CASETERA 3 KM 787.1
ARROYO PR
00714
US

IV. Provider business mailing address

PO BOX 1049
ARROYO PR
00714-1049
US

V. Phone/Fax

Practice location:
  • Phone: 787-839-0404
  • Fax:
Mailing address:
  • Phone: 787-839-0404
  • Fax: 787-839-7997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number9498
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: