Provider Demographics
NPI:1851768469
Name:BAEZ SANTOS, WILLIAM
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:BAEZ SANTOS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 CALLE 2 CARR.165
Mailing Address - Street 2:METRO OFFICE PARK LOTE 1 VALENCIA 5TO PISO
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968-1750
Mailing Address - Country:US
Mailing Address - Phone:787-622-9797
Mailing Address - Fax:
Practice Address - Street 1:10 CALLE A LOCAL 3 Y 4
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-0791
Practice Address - Country:US
Practice Address - Phone:787-248-1302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-31
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR72511163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse