Healthcare Provider Details

I. General information

NPI: 1699680348
Provider Name (Legal Business Name): KATHIANA SANTIAGO PONS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

COM CARACOLES 2 PARCELA 559
PENUELAS PR
00624
US

IV. Provider business mailing address

COM CARACOLES 2 BUZON 467
PENUELAS PR
00624
US

V. Phone/Fax

Practice location:
  • Phone: 787-407-1140
  • Fax:
Mailing address:
  • Phone: 787-407-1140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number001376
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: