Provider Demographics
NPI:1114680667
Name:SANTIAGO, CECILIA TERESA (MSN)
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:TERESA
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE20 TOA ALTA HEIGHTS
Mailing Address - Street 2:P-32
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953
Mailing Address - Country:US
Mailing Address - Phone:787-240-1799
Mailing Address - Fax:
Practice Address - Street 1:AVE. HOSTOS ESQ. CARR 831
Practice Address - Street 2:SANTA JUANITA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-778-4962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-20
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR27825163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse