Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 170100000X | Medical Geneticist | ||
Y | 208D00000X | General Practice Physician | 7671 | PR |
NPI | 1952398844 |
---|---|
Provider Name | Dr. Jose Efrain Santiago Santiago |
First Address | Cayey, PR 00737-1090 |
Second Address | Cayey, PR 00736-4745 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2005 |
Last Update Date | 08/06/2021 |