Provider Demographics
NPI:1548905433
Name:SANTIAGO-LABOY, AGNES (MD)
Entity type:Individual
Prefix:
First Name:AGNES
Middle Name:
Last Name:SANTIAGO-LABOY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF PUERTO RICO - MEDICAL SCIENCES CAMPUS
Mailing Address - Street 2:AVE. AMERICO MIRANDA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921
Mailing Address - Country:US
Mailing Address - Phone:787-474-0333
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF PUERTO RICO - MEDICAL SCIENCES CAMPUS
Practice Address - Street 2:AVE. AMERICO MIRANDA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-0728
Practice Address - Country:US
Practice Address - Phone:787-474-0333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-04
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17069208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics