Provider Demographics
NPI:1740240217
Name:SANTIAGO VEGA, ZAIDA (PT)
Entity Type:Individual
Prefix:MRS
First Name:ZAIDA
Middle Name:
Last Name:SANTIAGO VEGA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:C6 CALLE YAGRUMO
Mailing Address - Street 2:COLINAS DE GUAYNABO
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-6207
Mailing Address - Country:US
Mailing Address - Phone:787-790-2598
Mailing Address - Fax:787-790-2598
Practice Address - Street 1:C6 CALLE YAGRUMO
Practice Address - Street 2:COLINAS DE GUAYNABO
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-6207
Practice Address - Country:US
Practice Address - Phone:787-790-2598
Practice Address - Fax:787-790-2598
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-27
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR435225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR81381Medicare ID - Type UnspecifiedPROVIDER NUMBER