Provider Demographics
NPI:1841357498
Name:SANTIAGO, LINDA VIRGINIA (MSPT)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:VIRGINIA
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:971 CALLE GRAN CAPITAN
Mailing Address - Street 2:PALACIOS DE MARBELLA
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-5205
Mailing Address - Country:US
Mailing Address - Phone:787-585-3670
Mailing Address - Fax:787-799-5770
Practice Address - Street 1:971 CALLE GRAN CAPITAN
Practice Address - Street 2:PALACIOS DE MARBELLA
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953-5205
Practice Address - Country:US
Practice Address - Phone:787-585-3670
Practice Address - Fax:787-799-5770
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1356225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist