Individual
PEDRO JUAN SANTIAGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
39 CALLE BETANCES, PUEBLO, BAYAMON, PR 00961-6207
(787) 395-7816
(787) 395-7816
Mailing address
M35 CALLE WILSON, URB. PARKVILLE, GUAYNABO, PR 00969-3950
(787) 607-6985
(787) 395-7816
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
1344
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40D2104058
CMS
PR
Enumeration date
08/09/2016
Last updated
08/09/2016
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