Basic Information
| Provider Information | |||||||||
| NPI: | 1851349369 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SANTIAGO CUMMINGS | ||||||||
| FirstName: | MANUEL | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8 CALLE CEIBA | ||||||||
| Address2: | MANSIONES DEL SUR | ||||||||
| City: | COTO LAUREL | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007802075 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878486567 | ||||||||
| FaxNumber: | 7872848045 | ||||||||
| Practice Location | |||||||||
| Address1: | HOSPITAL DAMAS | ||||||||
| Address2: | |||||||||
| City: | PONCE | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00733 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878401445 | ||||||||
| FaxNumber: | 7872848045 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2006 | ||||||||
| LastUpdateDate: | 07/19/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 9957 | PR | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 82348 | 01 | PR | TRIPLE-S | OTHER |