Provider Demographics
NPI:1376587998
Name:SANTIAGO-GARCIA, MIGUEL A (MD)
Entity Type:Individual
Prefix:
First Name:MIGUEL
Middle Name:A
Last Name:SANTIAGO-GARCIA
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 190990
Mailing Address - Street 2:HATO REY STATION
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-0990
Mailing Address - Country:US
Mailing Address - Phone:787-769-2477
Mailing Address - Fax:787-276-0065
Practice Address - Street 1:ROAD #3 KM 12.3
Practice Address - Street 2:65 AVENUE
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-769-2477
Practice Address - Fax:787-276-0065
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9127207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRD38358Medicare UPIN
PR83501AMedicare ID - Type Unspecified