Provider Demographics
NPI:1720652308
Name:BONES SANTIAGO, ERIC JOSE (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:JOSE
Last Name:BONES SANTIAGO
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 1:1791 CALLE ESTEBAN PADILLA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-4237
Mailing Address - Country:US
Mailing Address - Phone:787-783-0399
Mailing Address - Fax:
Practice Address - Street 1:1791 CALLE ESTEBAN PADILLA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-4237
Practice Address - Country:US
Practice Address - Phone:787-783-0399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-18
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR390200000X
PR23521208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty