Provider Demographics
NPI:1013022409
Name:ROSA SANTIAGO, HELEN (MD)
Entity Type:Individual
Prefix:DR
First Name:HELEN
Middle Name:
Last Name:ROSA SANTIAGO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:HELEN
Other - Middle Name:
Other - Last Name:ROSA DE HERNANDEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:10 CALLE VEREDA
Mailing Address - Street 2:URB. MONTEVERDE REAL
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-5985
Mailing Address - Country:US
Mailing Address - Phone:787-764-7733
Mailing Address - Fax:787-764-4918
Practice Address - Street 1:PLAZA LAS AMERICAS
Practice Address - Street 2:TORRE DE PLAZA SUITE 601
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-8001
Practice Address - Country:US
Practice Address - Phone:787-764-7733
Practice Address - Fax:787-764-4918
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7798207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE-02411Medicare UPIN
PR8-4221Medicare ID - Type Unspecified