Individual
DR. SANTIAGO ELI MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
CARR 844 KM 4.2, CUPEY BAJO, SAN JUAN, PR 00926
(787) 760-0770
(787) 998-4415
Mailing address
LE93 VIA PARIS, L ANTIGUA, TRUJILLO ALTO, PR 00976-5414
(787) 585-4917
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
17361
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17361
STATE LICENSE
PR
Enumeration date
10/09/2008
Last updated
10/15/2015
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