Provider Demographics
NPI:1891463188
Name:SANTIAGO RAMIREZ, DANIEL JOSUE (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:JOSUE
Last Name:SANTIAGO RAMIREZ
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:EDIF MEDICO SANTA CRUZ # 402
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-6910
Mailing Address - Country:US
Mailing Address - Phone:787-245-7122
Mailing Address - Fax:
Practice Address - Street 1:EDIF MEDICO SANTA CRUZ # 402
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6910
Practice Address - Country:US
Practice Address - Phone:787-989-9285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-01
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22522208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR66-1702208Medicaid