Provider Demographics
NPI:1275727802
Name:HERNANDEZ-SANTIAGO, RUBEN AUGUSTO (MD)
Entity Type:Individual
Prefix:DR
First Name:RUBEN
Middle Name:AUGUSTO
Last Name:HERNANDEZ-SANTIAGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 8989
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00732-8989
Mailing Address - Country:US
Mailing Address - Phone:787-651-5580
Mailing Address - Fax:787-848-0318
Practice Address - Street 1:2435 BLVD LUIS A FERRE
Practice Address - Street 2:HOSPITAL DR. PILA, PRIMER PISO
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-2112
Practice Address - Country:US
Practice Address - Phone:787-651-5580
Practice Address - Fax:787-848-0318
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-27
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16588207XS0114X
NY241353207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRHT673ZMedicare PIN
PR0027701Medicare PIN