Provider Demographics
NPI:1467850917
Name:SANTIAGO TORRES, EDWARD
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:SANTIAGO TORRES
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 1:10 FLAMINGO APARTMENTS 10401
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:USA
Mailing Address - Zip Code:00959
Mailing Address - Country:UM
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10 FLAMINGO APARTMENTS 10401
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:USA
Practice Address - Zip Code:00959
Practice Address - Country:UM
Practice Address - Phone:787-854-3131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-16
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR29452471M1202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance Imaging