Healthcare Provider Details

I. General information

NPI: 1477648020
Provider Name (Legal Business Name): MISS LUANNA ZOE SANTIAGO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HC-03 BOX 33358
HATILLO PR
00659-9616
US

IV. Provider business mailing address

HC-03 BOX 33358
HATILLO PR
00659-9616
US

V. Phone/Fax

Practice location:
  • Phone: 787-262-4376
  • Fax:
Mailing address:
  • Phone: 787-262-4376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1026
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: