Provider Demographics
NPI:1821719857
Name:ROBAINA SANTIAGO, GRISSELLE M (MD)
Entity Type:Individual
Prefix:
First Name:GRISSELLE
Middle Name:M
Last Name:ROBAINA SANTIAGO
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:O37 CALLE 3
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00983-1518
Mailing Address - Country:US
Mailing Address - Phone:939-281-9016
Mailing Address - Fax:
Practice Address - Street 1:O37 CALLE 3
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983-1518
Practice Address - Country:US
Practice Address - Phone:939-281-9016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-08
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22874208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice