Provider Demographics
NPI:1891216313
Name:SANTIAGO PINTADO, ANNELISSE (MD)
Entity Type:Individual
Prefix:
First Name:ANNELISSE
Middle Name:
Last Name:SANTIAGO PINTADO
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 1:983135 NEBRASKA MEDICAL CENTER
Mailing Address - Street 2:UNIVERSITY OF NEBRASKA MEDICAL CENTER
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:69198-3135
Mailing Address - Country:US
Mailing Address - Phone:405-559-7636
Mailing Address - Fax:
Practice Address - Street 1:198 CALLE TRINIDAD STE 102
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-2900
Practice Address - Country:US
Practice Address - Phone:787-726-5486
Practice Address - Fax:787-268-4417
Is Sole Proprietor?:No
Enumeration Date:2017-07-06
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8033390200000X
PR22629207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program