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NPI Code Detail

MEDICARE: JORGE LUIS SANTIAGO

MEDICARE:   JORGE LUIS SANTIAGO
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
1164W00000XLicensed Practical Nurse25953PR

General Provider Information

NPI Number : 1316172539
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORGE LUIS SANTIAGO
Provider Business Mailing Address
First Line : CALLE CANADAS 1324
Second Line : CENTRO SALUD MENTAL SAN PATRICIO
City : SAN JUAN
State : PR
Zip : 00921-0000
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : CALLE CANADAS 1324
Second Line : CENTRO SALUD MENTAL SAN PATRICIO
City : SAN JUAN
State : PR
Zip : 00921-0000
Country : US
Telephone Number : 787-793-1550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2009
Last Update Date : 05/18/2009

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Directions to “ JORGE LUIS SANTIAGO ” Practice Location

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