Provider Demographics
NPI:1841496122
Name:SANTIAGO ALVARADO, JOSE OSCAR SR (MD)
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:OSCAR
Last Name:SANTIAGO ALVARADO
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:CONDOMINIO SAN VICENTE 8169
Mailing Address - Street 2:CALLE CONCORDIA SUITE 305
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-1563
Mailing Address - Country:US
Mailing Address - Phone:787-842-7981
Mailing Address - Fax:787-840-4296
Practice Address - Street 1:CONDOMINIO SAN VICENTE 8169
Practice Address - Street 2:CALLE CONCORDIA SUITE 305
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1563
Practice Address - Country:US
Practice Address - Phone:787-842-7981
Practice Address - Fax:787-840-4296
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14081207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H95798Medicare UPIN
PR0021647Medicare ID - Type Unspecified