Healthcare Provider Details

I. General information

NPI: 1457437394
Provider Name (Legal Business Name): ROBIN SANTIAGO-DELGADO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 12/18/2023
Certification Date: 12/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PR-140, KM 56.3 BO. SAN AGUSTIN
FLORIDA PR
00650
US

IV. Provider business mailing address

PO BOX 2360
MANATI PR
00674-2360
US

V. Phone/Fax

Practice location:
  • Phone: 787-822-1111
  • Fax: 787-680-7814
Mailing address:
  • Phone: 787-822-1111
  • Fax: 787-680-7814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number15092
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: