Provider Demographics
NPI:1891422119
Name:SANCHEZ SANTIAGO, JOSE GABRIEL
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:GABRIEL
Last Name:SANCHEZ SANTIAGO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 1 BOX 3264
Mailing Address - Street 2:
Mailing Address - City:VILLALBA
Mailing Address - State:PR
Mailing Address - Zip Code:00766-9710
Mailing Address - Country:US
Mailing Address - Phone:787-216-8393
Mailing Address - Fax:
Practice Address - Street 1:CARR 149 KM 50
Practice Address - Street 2:
Practice Address - City:VILLABA
Practice Address - State:PR
Practice Address - Zip Code:00766
Practice Address - Country:US
Practice Address - Phone:787-216-8393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program