Provider Demographics
NPI:1508520768
Name:SANTIAGO, ALEXIS (REGISTER NURSE)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:SANTIAGO
Suffix:
Gender:M
Credentials:REGISTER NURSE
Other - Prefix:MR
Other - First Name:ALEXIS
Other - Middle Name:
Other - Last Name:SANTIAGO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:REGISTER NURSE
Mailing Address - Street 1:HC 05 BOX HATILLO
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659
Mailing Address - Country:US
Mailing Address - Phone:787-547-7328
Mailing Address - Fax:
Practice Address - Street 1:HC 05 BOX HATILLO
Practice Address - Street 2:
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659
Practice Address - Country:US
Practice Address - Phone:787-547-7328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR088772163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse