Provider Demographics
NPI:1124287313
Name:REYES SANTIAGO, OMAYRA (MD)
Entity type:Individual
Prefix:
First Name:OMAYRA
Middle Name:
Last Name:REYES SANTIAGO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:OMAYRA
Other - Middle Name:
Other - Last Name:REYES SANTIAGO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:HC 73 BOX 6440
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00736-9529
Mailing Address - Country:US
Mailing Address - Phone:787-520-7211
Mailing Address - Fax:787-520-7212
Practice Address - Street 1:CARR 14 KM 71.9
Practice Address - Street 2:INT BO MONTELLANO
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736
Practice Address - Country:US
Practice Address - Phone:787-520-7211
Practice Address - Fax:787-520-7212
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17646207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology