Basic Information
| Provider Information | |||||||||
| NPI: | 1952509952 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SANTIAGO | ||||||||
| FirstName: | MADELINE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1774 | ||||||||
| Address2: | |||||||||
| City: | VEGA ALTA | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00692 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7873459049 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | MEDICAL SCIENCES CAMPUS | ||||||||
| Address2: | UNIVERSITY OF PUERTO RICO DEPARMENT OF PEDRIATICS | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009365067 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877773535 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2007 | ||||||||
| LastUpdateDate: | 10/08/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 17607 | PR | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.