Active NPI
Mayra L. Santiago, LND
- Registered Dietitian
- San Juan, PR
National Provider Identifier
1205248747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1112
- Practice address
- Barrio Manacillo Centro Medico
San Juan, PR 00936-8344 - Phone
- (787) 480-2783
- NPI assigned
- Jun 2, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | 1112 | PR | |
| Registered Dietitian | 133V00000X | 1112 | PR | Primary |
Addresses
Primary practice location
Barrio Manacillo Centro Medico
San Juan, PR 00936-8344
Mailing address
PO Box 70344
Hospital San Juan Rafael Lopez Nussa PMB #079
San Juan, PR 00936-8344
Phone (787) 480-2700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1112 | PR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401667200000",
"number": "1205248747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 70344",
"address_2": "HOSPITAL SAN JUAN RAFAEL LOPEZ NUSSA PMB #079",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009368344",
"telephone_number": "787-480-2700",
"fax_number": "787-764-3643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BARRIO MANACILLO CENTRO MEDICO",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009368344",
"telephone_number": "787-480-2783"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTIAGO",
"first_name": "MAYRA",
"middle_name": "L.",
"name_prefix": "Mrs.",
"credential": "LND",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-02",
"last_updated": "2014-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "PR",
"license": "1112",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PR",
"license": "1112",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Juan, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.