Provider Demographics
NPI:1033194030
Name:SANTAELLA, HAMED EMILIO (MD)
Entity Type:Individual
Prefix:MR
First Name:HAMED
Middle Name:EMILIO
Last Name:SANTAELLA
Suffix:
Gender:M
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:PO BOX 1917
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00687
Mailing Address - Country:US
Mailing Address - Phone:787-833-6035
Mailing Address - Fax:787-265-7925
Practice Address - Street 1:61 MENDEZ VIGO ST EAST
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-833-6035
Practice Address - Fax:787-265-7925
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5477207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
2292OtherAMERICAN HEALTH
4815OtherFIREST MEDICAL
065472OtherCUG AZUL
7090028OtherHUMANA
213028OtherUTI
3905477OtherUAI
97196SAOtherTRIPLE S
4815OtherFIREST MEDICAL
7090028OtherHUMANA