# NELISSA J SANTIAGO

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174902571
- **Authorized official:** DR. NELISSA JOAN SANTIAGO OD (OPTOMETRIST)
- **Authorized official phone:** (787) 269-2099

## Contact information

- **Practice address:** 725 WEST MAIN AVE, BAYAMON, PR 00961-4201
- **Practice address phone:** (787) 269-2099
- **Practice address fax:** (787) 998-9057
- **Mailing address:** 4 CALLE 1, URB. LA CAMPINA, SAN JUAN, PR 00926-9635
- **Mailing address phone:** (787) 269-2099
- **Mailing address fax:** (787) 998-9057

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 435-020 | PR | Yes |

## Other

- **Enumeration date:** 05/19/2015
- **Last updated:** 05/19/2015