MEDICARE: DR. RICHARD SOLER SANTIAGO 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	207L00000X	Anesthesiology Physician	10645	PR

General Provider Information

NPI Number	:	1376542308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD SOLER SANTIAGO M.D

Provider Business Mailing Address
First Line	:	PO BOX 801057
Second Line	:
City	:	COTO LAUREL
State	:	PR
Zip	:	00780-1057
Country	:	US
Telephone Number	:	787-842-2300
Fax Number	:	787-842-7754

Provider Business Practice Location Address
First Line	:	CARR 506 SAN CRITOBAL AVENUE
Second Line	:
City	:	COTO LAUREL
State	:	PR
Zip	:	00780
Country	:	US
Telephone Number	:	787-844-4958
Fax Number	:	787-844-4958

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

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	07/08/2007

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