Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 8760 | PR |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 8760 | PR |
NPI | 1174678247 |
---|---|
Provider Name | Dr. Jose R Santana |
First Address | San Juan, PR 00929 |
Second Address | Carolina, PR 00985 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D08569 | (02) |