Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 21575 | PR |
N | 207P00000X | Emergency Physician | MD04652 | DC |
N | 207PP0204X | Pediatric Emergency Physician | 21575 | PR |
NPI | 1801236682 |
---|---|
Provider Name | Daniella Maria Santiago-Haddock |
First Address | Manati, PR 00674 |
Second Address | Bayamon, PR 00959 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2013 |
Last Update Date | 25/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
038514300 | (05) | PR |