Provider Demographics
NPI:1699746131
Name:RODRIGUEZ SANTIAGO, NEFTALI (MD)
Entity type:Individual
Prefix:DR
First Name:NEFTALI
Middle Name:
Last Name:RODRIGUEZ SANTIAGO
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:COND PASEO MONTE 1608
Mailing Address - Street 2:FELISA RINCON DE GAUTIER
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6665
Mailing Address - Country:US
Mailing Address - Phone:787-314-5388
Mailing Address - Fax:
Practice Address - Street 1:CALLE PARANA # 1716
Practice Address - Street 2:URB EL CEREZAL
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-766-2200
Practice Address - Fax:787-766-8548
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-01
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13320207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
H57473Medicare UPIN
20893Medicare ID - Type Unspecified