Provider Demographics
NPI:1003383399
Name:SANTIAGO SUAREZ, DEILY
Entity Type:Individual
Prefix:
First Name:DEILY
Middle Name:
Last Name:SANTIAGO SUAREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HACIENDA CONCORDIA
Mailing Address - Street 2:CALLE CLAVEL 11216
Mailing Address - City:SANTA ISABEL
Mailing Address - State:PR
Mailing Address - Zip Code:00757
Mailing Address - Country:US
Mailing Address - Phone:787-901-0381
Mailing Address - Fax:
Practice Address - Street 1:CARR 153 KM 12.4
Practice Address - Street 2:BO LAS FLORES
Practice Address - City:COAMO
Practice Address - State:PR
Practice Address - Zip Code:00769-0073
Practice Address - Country:US
Practice Address - Phone:787-901-0381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-25
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1197224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant