Provider Demographics
NPI:1700018835
Name:SANTIAGO CABAN, LUIS ALBERTO (MD)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:ALBERTO
Last Name:SANTIAGO CABAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:LUIS
Other - Middle Name:ALBERTO
Other - Last Name:SANTIAGO CABAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:27 CALLE ENRIQUE GONZALEZ
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00784
Mailing Address - Country:US
Mailing Address - Phone:787-864-2010
Mailing Address - Fax:
Practice Address - Street 1:27 CALLE ENRIQUE GONZALEZ
Practice Address - Street 2:
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784
Practice Address - Country:US
Practice Address - Phone:787-864-2010
Practice Address - Fax:787-864-5984
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-24
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR20679207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology