MEDICARE: JO ANN SANTIAGO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	13133	PR

General Provider Information

NPI Number	:	1114910346
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JO ANN SANTIAGO MD

Provider Business Mailing Address
First Line	:	PO BOX 8459
Second Line	:	FERNANDEZ JUNCOS STATION
City	:	SAN JUAN
State	:	PR
Zip	:	00910-0459
Country	:	US
Telephone Number	:	787-725-6713
Fax Number	:

Provider Business Practice Location Address
First Line	:	SAN RAFAEL 1396
Second Line	:	SUITE #5 MEDICAL PAVILION
City	:	SAN JUAN
State	:	PR
Zip	:	00910
Country	:	US
Telephone Number	:	787-725-6713
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	01/26/2016

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