Provider Demographics
NPI:1861682320
Name:SANTOS-ALICEA, ANTONIA (MSPT)
Entity Type:Individual
Prefix:
First Name:ANTONIA
Middle Name:
Last Name:SANTOS-ALICEA
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 CALLE ZAFIRO
Mailing Address - Street 2:COND. PISOS DE SANTA ANA A-3
Mailing Address - City:VEGA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00692-6063
Mailing Address - Country:US
Mailing Address - Phone:787-883-1100
Mailing Address - Fax:787-883-1100
Practice Address - Street 1:50 CALLE ZAFIRO
Practice Address - Street 2:COND. PISOS DE SANTA ANA A-3
Practice Address - City:VEGA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00692-6063
Practice Address - Country:US
Practice Address - Phone:787-883-1100
Practice Address - Fax:787-883-1100
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1357225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist