Healthcare Provider Details

I. General information

NPI: 1629525043
Provider Name (Legal Business Name): ANA MARIA ORTIZ-SANTIAGO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2016
Last Update Date: 01/20/2025
Certification Date: 01/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

264 CALLE CONVENTO
SAN JUAN PR
00912-3207
US

IV. Provider business mailing address

200 CALLE ALCALA APT 2302
SAN JUAN PR
00921-3953
US

V. Phone/Fax

Practice location:
  • Phone: 787-723-7554
  • Fax:
Mailing address:
  • Phone: 939-639-9676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License Number23193
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number125077341
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: