Provider Demographics
NPI:1174678247
Name:SANTANA, JOSE R (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:R
Last Name:SANTANA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:BOX 30819
Mailing Address - Street 2:65TH INF STATION
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00929
Mailing Address - Country:US
Mailing Address - Phone:787-667-3446
Mailing Address - Fax:787-769-1630
Practice Address - Street 1:ST 11
Practice Address - Street 2:BLG 33 #22 VILLA CAROLINA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-769-1630
Practice Address - Fax:787-769-1630
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR8760207Q00000X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D08569Medicare UPIN
80361Medicare ID - Type Unspecified