Provider Demographics
NPI:1679072300
Name:SANCHEZ SANTANA, DARITZA L
Entity Type:Individual
Prefix:
First Name:DARITZA
Middle Name:L
Last Name:SANCHEZ SANTANA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CITA
Other - Middle Name:
Other - Last Name:MED
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CITAMED
Mailing Address - Street 1:C79 CALIXTO CARRERA
Mailing Address - Street 2:
Mailing Address - City:SABANA GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00637
Mailing Address - Country:US
Mailing Address - Phone:787-314-3431
Mailing Address - Fax:787-804-0472
Practice Address - Street 1:C79 CALIXTO CARRERA
Practice Address - Street 2:
Practice Address - City:SABANA GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00637
Practice Address - Country:US
Practice Address - Phone:787-314-3431
Practice Address - Fax:787-804-0472
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-08
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR$$$$$$$$$OtherMEDICARE Y MUCHO MAS