Provider Demographics
NPI:1861449324
Name:SANTORY-PENA, JULIO (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIO
Middle Name:
Last Name:SANTORY-PENA
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 6152
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-6152
Mailing Address - Country:US
Mailing Address - Phone:787-733-4261
Mailing Address - Fax:
Practice Address - Street 1:URB IMMACULADA CALLE 1
Practice Address - Street 2:CASA 103
Practice Address - City:LAS PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00771-0957
Practice Address - Country:US
Practice Address - Phone:787-733-4261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4992208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRD400235OtherMMM
PR063818OtherCRUZ AZUL
PRPG-2657OtherPALIC
PR2347-1OtherPROSSAM
PR1590OtherINTERNATIONAL
PR3922114OtherCIGNA
PR0010357OtherHUMANA
PR026007SAOtherTRIPLE S
PR201524OtherPREFERED
PR3922114OtherCIGNA
PRE-31198Medicare UPIN