MEDICARE: DR. ALBERTO SANTIAGO CORNIER M.D.

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	207SG0201X	Clinical Genetics (M.D.) Physician	11117	PR

General Provider Information

NPI Number	:	1285763144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALBERTO SANTIAGO CORNIER M.D.

Provider Business Mailing Address
First Line	:	PO BOX 87
Second Line	:
City	:	MAYAGUEZ
State	:	PR
Zip	:	00681-0087
Country	:	US
Telephone Number	:	787-728-8316
Fax Number	:	787-728-8316

Provider Business Practice Location Address
First Line	:	252 SAN JORGE STREET
Second Line	:	SUITE 408
City	:	SANTURCE
State	:	PR
Zip	:	00912-0000
Country	:	US
Telephone Number	:	787-728-8316
Fax Number	:	787-728-8316

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

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	07/08/2007

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