Healthcare Provider Details

I. General information

NPI: 1437799004
Provider Name (Legal Business Name): ANTONIO JOSE SANTIAGO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2020
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CENTRO MEDICO DE PUERTO RICO, BO. MONACILLOS, SAN JUAN HOSPITAL MUNICIPAL DE SAN JUAN
SAN JUAN PR
00936
US

IV. Provider business mailing address

QUINTAS LAS MUESAS 186 ROBERTO DIAZ
CAYEY PR
00736
US

V. Phone/Fax

Practice location:
  • Phone: 787-480-2700
  • Fax:
Mailing address:
  • Phone: 787-391-0011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number24041
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: