Provider Demographics
NPI:1427898832
Name:SANTIAGO-RIVERA, LUIS R (DO)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:R
Last Name:SANTIAGO-RIVERA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:URB VISTA DE CAMUY
Mailing Address - Street 2:CALLE 1 B 9
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627
Mailing Address - Country:US
Mailing Address - Phone:787-442-4544
Mailing Address - Fax:787-970-8115
Practice Address - Street 1:CARETERA 2 KM 56.6
Practice Address - Street 2:BO FLORIDA AFUERA
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617
Practice Address - Country:US
Practice Address - Phone:787-970-8105
Practice Address - Fax:787-970-8115
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-31
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR372156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician