Provider Demographics
NPI:1417382748
Name:SANTIAGO, GRICEL (RESPIRATORY THERAPIS)
Entity Type:Individual
Prefix:MRS
First Name:GRICEL
Middle Name:
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:RESPIRATORY THERAPIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 CALLE DR VEVE
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-4050
Mailing Address - Country:US
Mailing Address - Phone:939-264-9307
Mailing Address - Fax:787-892-5901
Practice Address - Street 1:HC 1 BOX 8962
Practice Address - Street 2:
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-9767
Practice Address - Country:US
Practice Address - Phone:939-264-9307
Practice Address - Fax:787-892-5901
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2144227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified