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General NPI Number Information
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NPI Number | 1336593474
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Entity Type | Individual
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Provider Name | DR. FELIX OMAR SANTIAGO
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Gender | Male
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Dates
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Enumeration Date | 04/14/2016
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Last Update Date | 10/12/2018
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Provider Practice Location Address
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Address Line | 430 AVE. SAN CLAUDIO URB. SAGRADO CORAZON
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | US
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Telephone | 787-761-0888
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Fax |
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Provider Business Mailing Address
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Address Line | HC 1 BOX 5271
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City | CIALES
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State | PR
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Zip | 00638
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3274
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License Number State | PR
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