Basic Information
Provider Information | |||||||||
NPI: | 1982905329 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | RODRIGUEZ-SANTIAGO | ||||||||
FirstName: | SULIMAR | ||||||||
MiddleName: |   | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | MEDICINA INTERNA RCM | ||||||||
Address2: | PO BOX 29134 | ||||||||
City: | SAN JUAN | ||||||||
State: | PR | ||||||||
PostalCode: | 009290134 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7877516034 | ||||||||
FaxNumber: | 7877541739 | ||||||||
Practice Location | |||||||||
Address1: | HOSPITAL UNIVERSITARIO DE ADULTOS | ||||||||
Address2: | CENTRO MEDICO DE PR, BO MONACILLOS | ||||||||
City: | SAN JUAN | ||||||||
State: | PR | ||||||||
PostalCode: | 00935 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7877540101 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 11/16/2010 | ||||||||
LastUpdateDate: | 11/26/2018 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 18585 | PR | N |   | Allopathic & Osteopathic Physicians | Internal Medicine |   | 207RG0100X | 18585 | PR | Y |   | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.