Individual
SANTOS SANTIAGO MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
AVE LAS AMERICAS 2401, EDIFICIO PORRATA PILA #207, PONCE, PR 00717-2115
(787) 841-1141
(787) 841-1142
Mailing address
PO BOX 800378, COTO LAUREL, PR 00780-0378
(787) 841-1141
(787) 841-1142
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
6223
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
067249
CRUZ AZUL
—
01
—
209302
UTI
—
01
—
3706223
UIA
—
01
—
600090
MMM
—
01
—
6424
IMC
—
01
—
7330017
HUMANA
—
01
—
80918
TRIPLE S
—
01
—
PE 3807
PALIC
—
Enumeration date
12/28/2005
Last updated
06/04/2014
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