Provider Demographics
NPI:1942409859
Name:RAMOS SANTIAGO, JORGE A
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:A
Last Name:RAMOS 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 64 BOX 8487
Mailing Address - Street 2:BO. GUARDARRAYA
Mailing Address - City:PATILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00723-9732
Mailing Address - Country:US
Mailing Address - Phone:787-486-8875
Mailing Address - Fax:
Practice Address - Street 1:HC 64 BOX 8487
Practice Address - Street 2:CARR 7758 KM 1 BO GUARDARRAYA
Practice Address - City:PATILLAS
Practice Address - State:PR
Practice Address - Zip Code:00723
Practice Address - Country:US
Practice Address - Phone:787-486-8875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2999104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2999OtherSOCIAL WORKER