Provider Demographics
NPI:1548415177
Name:SANTIAGO ROLON, AMARILYS (MD)
Entity Type:Individual
Prefix:DR
First Name:AMARILYS
Middle Name:
Last Name:SANTIAGO ROLON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 827
Mailing Address - Street 2:
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795
Mailing Address - Country:US
Mailing Address - Phone:787-239-7850
Mailing Address - Fax:866-325-4826
Practice Address - Street 1:PORTO FINO LOCAL 2
Practice Address - Street 2:CARR 3 KM 158.7
Practice Address - City:SALINAS
Practice Address - State:PR
Practice Address - Zip Code:00751
Practice Address - Country:US
Practice Address - Phone:787-239-7850
Practice Address - Fax:866-325-4826
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-24
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR27348207R00000X
PR18073207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR18073OtherLICENCIA