MEDICARE: ERNESTO GARCIA 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	207R00000X	Internal Medicine Physician	11239	PR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	400280	OTHER	PR	MEDICARE Y MUCHO MAS
2	1816	OTHER	PR	PREFERRED MEDICARE CHOICE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	7250241	OTHER	PR	HUMANA HEALTH PLAN
4	7250241	OTHER	PR	HUMANA REFORMA
5	89278	OTHER	PR	TRIPLE S PROVIDER NUMBER
6	11611234	OTHER	PR	GLOBAL HEALTH
7	03187	OTHER	PR	AMERICAN HEALTH
8	060558	OTHER	PR	CRUZ AZUL DE PUERTO RICO
9	212855	OTHER	PR	PREFERRED HEALTH
10	9449	OTHER	PR	FIRST MEDICAL
11	4311239	OTHER	PR	UIA
12	7250241	OTHER	PR	HUMANA INSURANCE

General Provider Information

NPI Number	:	1609820414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERNESTO GARCIA SANTIAGO M.D.

Provider Business Mailing Address
First Line	:	URB VILLA BLANCA
Second Line	:	20 AVE. LMM STE 1 PMB 115
City	:	CAGUAS
State	:	PR
Zip	:	00725-1956
Country	:	US
Telephone Number	:	787-961-4668
Fax Number	:	787-523-2886

Provider Business Practice Location Address
First Line	:	AVENIDA LUIS MUNOZ MARIN
Second Line	:	HIMA PLAZA 1 SUITE 312
City	:	CAGUAS
State	:	PR
Zip	:	00925-0000
Country	:	US
Telephone Number	:	787-961-4668
Fax Number	:	787-961-4674

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

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	04/14/2020

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