Provider Demographics
NPI:1942251392
Name:SILVA SANTANA, DAMARIS A (MD)
Entity Type:Individual
Prefix:
First Name:DAMARIS
Middle Name:A
Last Name:SILVA SANTANA
Suffix:
Gender:F
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:URB PANORAMA VILLAGE
Mailing Address - Street 2:E 117 CALLE VISTA DEL MORRO
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00957
Mailing Address - Country:US
Mailing Address - Phone:787-598-8764
Mailing Address - Fax:787-761-0613
Practice Address - Street 1:OFICINA MEDICA DRA DAMARIS A SILVA SANTANA
Practice Address - Street 2:AVENIDA BETANCES # 181 OFICINA B URB EXTENSION HERMANA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-598-8764
Practice Address - Fax:787-761-0613
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11918207R00000X
PR011918207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G41018Medicare UPIN
87922Medicare ID - Type Unspecified