Provider Demographics
NPI:1750031795
Name:HERNANDEZ-SANTIAGO, CAROLYN (OTR-L)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:HERNANDEZ-SANTIAGO
Suffix:
Gender:F
Credentials:OTR-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 2 BOX 31331
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-9212
Mailing Address - Country:US
Mailing Address - Phone:787-425-1169
Mailing Address - Fax:
Practice Address - Street 1:CARR. 695 KM 1.6 BO. HIGUILLAR URB. DORAVILLE
Practice Address - Street 2:
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-0000
Practice Address - Country:US
Practice Address - Phone:787-391-6951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1310225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist