Provider Demographics
NPI:1265035208
Name:SANTIAGO, PEDRO D
Entity Type:Individual
Prefix:
First Name:PEDRO
Middle Name:D
Last Name:SANTIAGO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB SAN TOMAS
Mailing Address - Street 2:CALLE ROBERTO SANTANA C 26
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716
Mailing Address - Country:US
Mailing Address - Phone:787-399-1525
Mailing Address - Fax:787-259-3292
Practice Address - Street 1:URB SAN TOMAS
Practice Address - Street 2:CALLE ROBERTO SANTANA C 26
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716
Practice Address - Country:US
Practice Address - Phone:787-399-1525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport