Provider Demographics
NPI:1346734225
Name:SANTIAGO-MERCADO, BEGGY LIZ (PHL)
Entity Type:Individual
Prefix:MRS
First Name:BEGGY
Middle Name:LIZ
Last Name:SANTIAGO-MERCADO
Suffix:
Gender:F
Credentials:PHL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:278 LOPE DE VEGA
Mailing Address - Street 2:
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-3639
Mailing Address - Country:US
Mailing Address - Phone:787-223-7964
Mailing Address - Fax:
Practice Address - Street 1:278 LOPE DE VEGA
Practice Address - Street 2:
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953-3639
Practice Address - Country:US
Practice Address - Phone:787-223-7964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-14
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4125235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR235Z00000XOtherSPEECH PATHOLOGIST