Provider Demographics
NPI:1306922943
Name:SANTIAGO, MARIA I
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:I
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 3 BOX 20250
Mailing Address - Street 2:
Mailing Address - City:LAJAS
Mailing Address - State:PR
Mailing Address - Zip Code:00667-9502
Mailing Address - Country:US
Mailing Address - Phone:787-808-3302
Mailing Address - Fax:
Practice Address - Street 1:218 BROOK ST
Practice Address - Street 2:BLDG 21
Practice Address - City:FORT BUCHANAN
Practice Address - State:PR
Practice Address - Zip Code:00934-4206
Practice Address - Country:US
Practice Address - Phone:787-707-2178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR000146163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health