Provider Demographics
NPI:1891701868
Name:SANTIAGO PEREZ, HECTOR M (MD)
Entity Type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:M
Last Name:SANTIAGO PEREZ
Suffix:
Gender:M
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:PO BOX 645
Mailing Address - Street 2:
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-0645
Mailing Address - Country:US
Mailing Address - Phone:787-892-4590
Mailing Address - Fax:787-892-4595
Practice Address - Street 1:SAN GERMAN MEDICAL PLAZA
Practice Address - Street 2:STE 211 CARR 2 KM 174
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683
Practice Address - Country:US
Practice Address - Phone:787-892-4590
Practice Address - Fax:787-892-4595
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13582207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR13582OtherMEDICAL LICENSE
PR13582OtherMEDICAL LICENSE
PR0021478Medicare PIN