Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 21372 | PR |
NPI | 1003255431 |
---|---|
Provider Name | Dr. Juan Carlos Perez-Santiago |
First Address | Guaynabo, PR 00971 |
Second Address | Bayamon, PR 00961 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2013 |
Last Update Date | 21/09/2020 |