Individual
ILDEFONSO SANTIAGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 CALLE PARQUE W, CABO ROJO, PR 00623-3735
(787) 255-0636
(787) 851-2697
Mailing address
P O BOX 1847, CABO ROJO, PR 00623-1847
(787) 255-0636
(787) 851-2697
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
TC AMB 310
PR
Other
Enumeration date
07/26/2007
Last updated
07/26/2007
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