Provider Demographics
NPI:1205862562
Name:SANJURJO, SANDRA I
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:I
Last Name:SANJURJO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 CALLE TAPIA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00911-2320
Mailing Address - Country:US
Mailing Address - Phone:787-319-8180
Mailing Address - Fax:
Practice Address - Street 1:1429 AVE PAZ GRANELA
Practice Address - Street 2:URB SANTIAGO IGLESIAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-4128
Practice Address - Country:US
Practice Address - Phone:787-273-1227
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR246Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Y00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health Information
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRTP018OtherTRIPLE-S ELEC. BILLING NO
PRTP018OtherTRIPLE-S ELEC. BILLING NO