Provider Demographics
NPI:1801051933
Name:SANTOS SANTIAGO, ALEXI (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXI
Middle Name:
Last Name:SANTOS 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 1:2725 CALLE COROZO
Mailing Address - Street 2:LOS CAOBOS
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-2734
Mailing Address - Country:US
Mailing Address - Phone:787-424-5794
Mailing Address - Fax:
Practice Address - Street 1:AVE. TITO CASTRO #917 CARRETERA14
Practice Address - Street 2:HOSPITAL EPISCOPAL SAN LUCAS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00731
Practice Address - Country:US
Practice Address - Phone:787-844-2080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-29
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18206207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine