Provider Demographics
NPI:1134358369
Name:SANTIAGO RODRIGUEZ, ARELIS (OTL)
Entity type:Individual
Prefix:
First Name:ARELIS
Middle Name:
Last Name:SANTIAGO RODRIGUEZ
Suffix:
Gender:F
Credentials:OTL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 CALLE GEORGETTI
Mailing Address - Street 2:
Mailing Address - City:NARANJITO
Mailing Address - State:PR
Mailing Address - Zip Code:00719-3012
Mailing Address - Country:US
Mailing Address - Phone:787-869-7213
Mailing Address - Fax:787-869-7213
Practice Address - Street 1:130 CALLE GEORGETTI
Practice Address - Street 2:
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719-3012
Practice Address - Country:US
Practice Address - Phone:787-869-7213
Practice Address - Fax:787-869-7213
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1113225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist