=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902721707
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LISANDRA SANTIAGO M.S., SLP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/11/2026
-----------------------------------------------------
Last Update Date | 08/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 65 DE INFANTERIA ESQUINA VICTORIA
-----------------------------------------------------
City | LAJAS
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00667
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-899-8006
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 199 CALLE CANARIO
-----------------------------------------------------
City | CABO ROJO
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00623-4230
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-974-6640
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | 4777
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------