Provider Demographics
NPI:1033544028
Name:SANTOS, RAFAEL A (MA)
Entity Type:Individual
Prefix:MR
First Name:RAFAEL
Middle Name:A
Last Name:SANTOS
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:FLORIDIANO
Mailing Address - Street 2:403
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-7664
Mailing Address - Country:US
Mailing Address - Phone:787-364-6703
Mailing Address - Fax:
Practice Address - Street 1:CALLE FLORIDIANO
Practice Address - Street 2:403
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987-7657
Practice Address - Country:US
Practice Address - Phone:787-364-6703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-09
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4342103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist