Provider Demographics
NPI:1841059821
Name:RAMIREZ SANTIAGO, KEYZA (PHL)
Entity type:Individual
Prefix:MRS
First Name:KEYZA
Middle Name:
Last Name:RAMIREZ SANTIAGO
Suffix:
Gender:F
Credentials:PHL
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 308
Mailing Address - Street 2:
Mailing Address - City:PENUELAS
Mailing Address - State:PR
Mailing Address - Zip Code:00624-0308
Mailing Address - Country:US
Mailing Address - Phone:787-672-2877
Mailing Address - Fax:
Practice Address - Street 1:3 CALLE BALDORIOTY
Practice Address - Street 2:
Practice Address - City:SABANA GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00637-1823
Practice Address - Country:US
Practice Address - Phone:787-941-8278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR004434235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty