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General NPI Number Information
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NPI Number | 1821600230
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Entity Type | Organization
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Legal Business Name | LUIS G SANTIAGO BALBES
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Dates
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Enumeration Date | 08/18/2020
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Last Update Date | 09/08/2020
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Provider Practice Location Address
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Address Line | 6 CALLE LA CRUZ
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City | JUANA DIAZ
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State | PR
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Zip | 00795-2430
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Country | US
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Telephone | 787-432-4569
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Fax |
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Provider Business Mailing Address
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Address Line | URB HACIENDA CONCORDIA 11077 CALLE GERANIO
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City | SANTA ISABEL
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State | PR
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Zip | 00757
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Country | US
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Telephone | 787-432-4569
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LUIS G SANTIAGO
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Credential |
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Telephone | 787-432-4569
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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