Provider Demographics
NPI:1639101264
Name:SANTIAGO MENDEZ, ISAMIR (MD)
Entity Type:Individual
Prefix:DR
First Name:ISAMIR
Middle Name:
Last Name:SANTIAGO MENDEZ
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:VISTA AZUL CALLE 11 K-18
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-2522
Mailing Address - Country:US
Mailing Address - Phone:787-531-6255
Mailing Address - Fax:
Practice Address - Street 1:CARR. # 2 INTL 668
Practice Address - Street 2:URB. ATENAS CALLE HERNANDEZ CARRION
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-621-3700
Practice Address - Fax:787-621-3798
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15556207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine