Provider Demographics
NPI:1538898267
Name:RIOS SANTIAGO, JESSICA (MD)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:
Last Name:RIOS SANTIAGO
Suffix:
Gender:F
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:PO BOX 495
Mailing Address - Street 2:
Mailing Address - City:ADJUNTAS
Mailing Address - State:PR
Mailing Address - Zip Code:00601-0495
Mailing Address - Country:US
Mailing Address - Phone:787-379-9099
Mailing Address - Fax:
Practice Address - Street 1:CAR 129 KM 3 HM 4 PORTILLO
Practice Address - Street 2:
Practice Address - City:ADJUNTAS
Practice Address - State:PR
Practice Address - Zip Code:00601
Practice Address - Country:US
Practice Address - Phone:787-379-9099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR022713208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR022713OtherN/A