Provider Demographics
NPI:1124288618
Name:SANTIAGO-CARABALLO, DANIA LUZ (MD)
Entity type:Individual
Prefix:
First Name:DANIA
Middle Name:LUZ
Last Name:SANTIAGO-CARABALLO
Suffix:
Gender:F
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:AVE 22 SAN IGNACIO
Mailing Address - Street 2:COND PLAZA DEL PALMAR APT 109
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-349-2423
Mailing Address - Fax:
Practice Address - Street 1:MMC PROFESSIONAL PLAZA
Practice Address - Street 2:SUITE 103
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-884-7202
Practice Address - Fax:787-854-7768
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-10
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR17468207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine