Active NPI
Eduardo Rodriguez Santiago, 1562B
- Medical Physician Assistant
- Ponce, PR
National Provider Identifier
1295949865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 079-PA
- Practice address
- Parra Medical Plaza Ave Ponce by Pass
Suite 904-905
Ponce, PR 00717 - Phone
- (787) 844-2710
- Fax
- (787) 844-2832
- NPI assigned
- May 10, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Basic Emergency Medical Technician | 146N00000X | 1562B | PR | |
| Medical Physician Assistant | 363AM0700X | 079-PA | PR | Primary |
Addresses
Primary practice location
Parra Medical Plaza Ave Ponce by Pass
Suite 904-905
Ponce, PR 00717
Mailing address
PO Box 1292
Cabo Rojo, PR 00623-1292
Phone (787) 231-5758
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 |
|---|---|---|---|
| 1562B | PR | MD | Basic Emergency Medical Technician |
| 079-PA | PR | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606953600000",
"number": "1295949865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1292",
"city": "CABO ROJO",
"state": "PR",
"postal_code": "006231292",
"telephone_number": "787-231-5758"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PARRA MEDICAL PLAZA AVE PONCE BY PASS",
"address_2": "SUITE 904-905",
"city": "PONCE",
"state": "PR",
"postal_code": "00717",
"telephone_number": "787-844-2710",
"fax_number": "787-844-2832"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ SANTIAGO",
"first_name": "EDUARDO",
"credential": "1562B",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-10",
"last_updated": "2020-12-03",
"certification_date": "2020-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "146N00000X",
"taxonomy_group": "",
"desc": "Emergency Medical Technician, Basic",
"state": "PR",
"license": "1562B",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "PR",
"license": "079-PA",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ponce, PR
- Isairy Rodriguez Roman, PSYD.
- Michaell O Rodriguez Rosa
- Daniel Eduardo Rodriguez Rossello, MD
- Carlos Manuel Rodriguez Roth, P.A.
- Marileana Rodriguez Ruiz
- Carlos Roberto Rodriguez Serrano
- Jetsen Amaury Rodriguez Silva, MD
- Kathiayari Rodriguez Silva, PSYD
- Araceli Rodriguez Soto, MD
- Nashali Ivette Rodriguez Soto
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.