Healthcare Provider Details

I. General information

NPI: 1225966500
Provider Name (Legal Business Name): RAFAEL J SANTIAGO MALDONADO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

2649 CALLE TETUAN
PONCE PR
00716-2227
US

IV. Provider business mailing address

2649 CALLE TETUAN VILLA DEL CARMEN
PONCE PR
00716-2227
US

V. Phone/Fax

Practice location:
  • Phone: 787-374-0513
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246YC3302X
TaxonomyPhysician Office Based Coding Specialist
License Number
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code246YC3301X
TaxonomyHospital Based Coding Specialist
License Number
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: