Individual
MR. EDISSON SANTIAGO SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
TEM
Contact information
Practice address
CAMUY ARRIBA, STREET 119 KM 11.1 INT, CAMUY, PR 00627-0000
(787) 898-0698
(787) 820-3198
Mailing address
PO BOX 141316, ARECIBO, PR 00614-1316
(787) 898-0698
(787) 820-3198
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
TCAMB407
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57984
TRIPLE S
PR
Enumeration date
07/21/2006
Last updated
12/04/2007
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