Provider Demographics
NPI:1649566977
Name:FERNANDEZ SANTOS, CARLOS JAVIER (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:JAVIER
Last Name:FERNANDEZ 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:PLAZA BAIROA
Mailing Address - Street 2:1 AVE FOMENTO SUITE 1
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-641-3030
Mailing Address - Fax:
Practice Address - Street 1:PLAZA BAIROA
Practice Address - Street 2:PR-1 CALLE SAKURA, STE 245
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-0072
Practice Address - Country:US
Practice Address - Phone:787-641-3030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-24
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19484207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology