Provider Demographics
NPI:1700341690
Name:SANTIAGO SANTOS, NATASHA NICOLE (MD)
Entity Type:Individual
Prefix:MRS
First Name:NATASHA
Middle Name:NICOLE
Last Name:SANTIAGO SANTOS
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:URB GLENVIEW GARDENS
Mailing Address - Street 2:X16 CALLE EDEN
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00731
Mailing Address - Country:US
Mailing Address - Phone:787-718-0828
Mailing Address - Fax:
Practice Address - Street 1:URB GLENVIEW GARDENS
Practice Address - Street 2:X16 CALLE EDEN
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730
Practice Address - Country:US
Practice Address - Phone:787-718-0828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program