Provider Demographics
NPI:1437367125
Name:ADVANCED INSTITUTE OF AUDIOLOGY PRO-HEARING AND AUDIOLOGY CONSULTANTS
Entity type:Organization
Organization Name:ADVANCED INSTITUTE OF AUDIOLOGY PRO-HEARING AND AUDIOLOGY CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLGIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SOAMI
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:787-738-8890
Mailing Address - Street 1:PO BOX 370624
Mailing Address - Street 2:CALLE LUCIA VAZQUEZ #65
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00737-0624
Mailing Address - Country:US
Mailing Address - Phone:787-738-8890
Mailing Address - Fax:787-738-8890
Practice Address - Street 1:65 CALLE LUCIA VAZQUEZ S
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736-4608
Practice Address - Country:US
Practice Address - Phone:787-738-8890
Practice Address - Fax:787-738-8890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR381302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization