Provider Demographics
NPI:1427085448
Name:SANTIAGO-PAGAN, LUIS RAUL (MD)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:RAUL
Last Name:SANTIAGO-PAGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 CALLE PEDRO ROSARIO
Mailing Address - Street 2:PO BOX 455
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-3238
Mailing Address - Country:US
Mailing Address - Phone:787-991-1325
Mailing Address - Fax:787-991-2305
Practice Address - Street 1:56 CALLE PEDRO ROSARIO
Practice Address - Street 2:
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705-3238
Practice Address - Country:US
Practice Address - Phone:787-991-1325
Practice Address - Fax:787-991-2305
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12782207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR89603Medicare ID - Type Unspecified