Provider Demographics
NPI:1467938795
Name:FLORES SANTIAGO, JOSEAN OMAR (MD)
Entity Type:Individual
Prefix:
First Name:JOSEAN
Middle Name:OMAR
Last Name:FLORES SANTIAGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:357 AV HOSTOS
Mailing Address - Street 2:OFFICE PARK II STE 203
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680
Mailing Address - Country:US
Mailing Address - Phone:939-475-3432
Mailing Address - Fax:787-806-2239
Practice Address - Street 1:357 HOSTOS AVE.
Practice Address - Street 2:OFFICE PARK II SUITE 203
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-1507
Practice Address - Country:US
Practice Address - Phone:939-475-3432
Practice Address - Fax:787-806-2200
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-19
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR023329207RN0300X
PR33934208D00000X
LA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program