Provider Demographics
NPI:1407890981
Name:SANTANA TORRES, LIZA M (MD)
Entity Type:Individual
Prefix:
First Name:LIZA
Middle Name:M
Last Name:SANTANA TORRES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3443 CALLE ATLANTICO
Mailing Address - Street 2:OCEAN FRONT
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693-6109
Mailing Address - Country:US
Mailing Address - Phone:787-608-4903
Mailing Address - Fax:787-884-9719
Practice Address - Street 1:CARR 2
Practice Address - Street 2:PARQUE INDUSTRIAL DCH
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-5765
Practice Address - Country:US
Practice Address - Phone:787-854-0824
Practice Address - Fax:787-884-9719
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR15,296207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2-3016Medicare ID - Type Unspecified
PRI31984Medicare UPIN