Provider Demographics
NPI:1386488609
Name:SANTIAGO, LUIS MANUEL (RN BSN)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:MANUEL
Last Name:SANTIAGO
Suffix:
Gender:M
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 2 BOX 71098
Mailing Address - Street 2:BO PALOMAS
Mailing Address - City:COMERIO
Mailing Address - State:PR
Mailing Address - Zip Code:00782
Mailing Address - Country:US
Mailing Address - Phone:787-367-9891
Mailing Address - Fax:
Practice Address - Street 1:PASEO DR. JOSE CELSO BARBOSA
Practice Address - Street 2:UNIVERSIDAD DE PUERTO RICO RECINTO DE CIENCIAS MEDICAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-758-2525
Practice Address - Fax:708-782-4290
Is Sole Proprietor?:No
Enumeration Date:2024-06-21
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRG-92245163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse