Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 13073 | PR |
NPI | 1053389650 |
---|---|
Provider Name | Annette Santiago |
First Address | Bayamon, PR 00961-3440 |
Second Address | Bayamon, PR 00961-3440 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2006 |
Last Update Date | 27/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
81512 | SSS (01) | PR |