Santiago De Jesus, Juan Carlos

Santiago De Jesus, Juan Carlos is an sole proprietor health care provider with primary practice located at Ctiam, 500 Pr-5 , Bayamon PR 00961. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Santiago De Jesus, Juan Carlos can be contacted via phone (787) 677-0141.

Contact Information

Primary practice address
Ctiam, 500 Pr-5 Bayamon PR 00961
Phone: (787) 677-0141
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 4696 Puerto Rico
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 299040 Puerto Rico

Profile Details

NPI number 1932837754
LBN Legal business name Santiago De Jesus, Juan Carlos
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 10th, 2022
Last updated Mar 5th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932837754 NPPES
Puerto Rico MEDICAID 1932837754

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