MEDICARE: DR. DAVID SANTIAGO OD

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	152WC0802X	Corneal and Contact Management Optometrist	140	PR
2	152W00000X	Optometrist	140	PR

General Provider Information

NPI Number	:	1902066608
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID SANTIAGO OD

Provider Business Mailing Address
First Line	:	J6 CALLE ARGENTINA
Second Line	:
City	:	GUAYNABO
State	:	PR
Zip	:	00969-3418
Country	:	US
Telephone Number	:	407-719-7770
Fax Number	:

Provider Business Practice Location Address
First Line	:	FT BUCHANAN EXCHANGE BUILDING 689, FT BUCHANAN
Second Line	:
City	:	GUAYNABO
State	:	PR
Zip	:	00934
Country	:	US
Telephone Number	:	787-781-6721
Fax Number	:

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

Provider Enumeration Date	:	06/16/2008
Last Update Date	:	04/25/2024

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