Provider Demographics
NPI:1386531036
Name:PADILLA SANTIAGO, JOSE ALEXIS
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ALEXIS
Last Name:PADILLA SANTIAGO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 645 BOX 6571
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-9742
Mailing Address - Country:US
Mailing Address - Phone:787-459-1700
Mailing Address - Fax:
Practice Address - Street 1:CARR 2 ESQUINA 167
Practice Address - Street 2:BAY SHOPPING CITY 6107
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-221-3971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1059111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor