Provider Demographics
NPI:1114938271
Name:SANZ DE LA PENA, DIEGO (MD)
Entity Type:Individual
Prefix:DR
First Name:DIEGO
Middle Name:
Last Name:SANZ DE LA PENA
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:CAMINO LAS PALMAS C-16
Mailing Address - Street 2:LOS PASEOS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-751-7370
Mailing Address - Fax:787-751-7470
Practice Address - Street 1:735 PONCE DE LEON AVE
Practice Address - Street 2:SUITE 206 AUXILIO MUTUO TOWER
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917
Practice Address - Country:US
Practice Address - Phone:787-751-7370
Practice Address - Fax:787-751-7470
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7410208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics