Provider Demographics
NPI:1366444689
Name:JUARBE SANTOS, CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:
Last Name:JUARBE 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:EDIFICIO MEDICO STA CRUZ 73
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:787-740-1120
Mailing Address - Fax:787-269-1565
Practice Address - Street 1:73 EDIF MEDICO SANTA CRUZ
Practice Address - Street 2:SUITE 205
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-740-1120
Practice Address - Fax:787-269-1565
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-01
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5777207Y00000X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0080649OtherMEDICARE PITAN
PR0080649OtherMEDICARE PITAN
PR80649Medicare ID - Type UnspecifiedPROVIDER NUMBER