Provider Demographics
NPI:1659541381
Name:SANTAELLA, RICARDO MIGUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:MIGUEL
Last Name:SANTAELLA
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:PO BOX 1917
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-1917
Mailing Address - Country:US
Mailing Address - Phone:787-834-2558
Mailing Address - Fax:787-265-7925
Practice Address - Street 1:ESQUINA CALLE DEL RIO
Practice Address - Street 2:MENDEZ VIGO #61 ESTE
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-834-2558
Practice Address - Fax:787-265-7925
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-10
Last Update Date:2010-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2008-00245207W00000X
PR17834207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology