Provider Demographics
NPI:1851420830
Name:SANTOS TORRES, COSME DAMIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:COSME
Middle Name:DAMIAN
Last Name:SANTOS TORRES
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 331990
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00733-1990
Mailing Address - Country:US
Mailing Address - Phone:787-841-8201
Mailing Address - Fax:787-841-8201
Practice Address - Street 1:3011 AVE EMILIO FAGOT
Practice Address - Street 2:VILLA ESPARANZA
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-3637
Practice Address - Country:US
Practice Address - Phone:787-841-8201
Practice Address - Fax:787-841-8201
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12026174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG27523Medicare UPIN
0020448BMedicare PIN
0088711AMedicare PIN