Provider Demographics
NPI:1194350421
Name:OTERO - SANTIAGO, CAROLINA (DC)
Entity type:Individual
Prefix:
First Name:CAROLINA
Middle Name:
Last Name:OTERO - SANTIAGO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 1 BOX 2370
Mailing Address - Street 2:
Mailing Address - City:MOROVIS
Mailing Address - State:PR
Mailing Address - Zip Code:00687-8246
Mailing Address - Country:US
Mailing Address - Phone:787-215-4297
Mailing Address - Fax:
Practice Address - Street 1:CARR 618 KM 1.8
Practice Address - Street 2:BO. CUCHILLAS
Practice Address - City:MOROVIS
Practice Address - State:PR
Practice Address - Zip Code:00687
Practice Address - Country:US
Practice Address - Phone:787-215-4297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-06
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR724111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor