Provider Demographics
NPI:1043271315
Name:ALONSO SANTOS, ANGEL A (MD)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:A
Last Name:ALONSO SANTOS
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 1:358 FONMARTELLO AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791
Mailing Address - Country:US
Mailing Address - Phone:787-850-1720
Mailing Address - Fax:787-852-4275
Practice Address - Street 1:358 CALLE FONT MARTELO
Practice Address - Street 2:SUITE 103
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-3222
Practice Address - Country:US
Practice Address - Phone:787-850-1720
Practice Address - Fax:787-852-4275
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5697207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine