Provider Demographics
NPI:1275197147
Name:SANTOS, ALIDA ESTHER (OTL, CEE)
Entity Type:Individual
Prefix:MRS
First Name:ALIDA
Middle Name:ESTHER
Last Name:SANTOS
Suffix:
Gender:F
Credentials:OTL, CEE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 1 BOX 2244-1
Mailing Address - Street 2:
Mailing Address - City:CIDRA
Mailing Address - State:PR
Mailing Address - Zip Code:00739-9830
Mailing Address - Country:US
Mailing Address - Phone:787-922-2256
Mailing Address - Fax:
Practice Address - Street 1:BARRIO MONACILLO
Practice Address - Street 2:CENTRO MEDICO HOSPITAL INDUSTRIAL
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936
Practice Address - Country:US
Practice Address - Phone:787-754-2525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-26
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR411225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist