Provider Demographics
NPI:1952300410
Name:CANTALAPIEDRA, SUSANA (MD)
Entity Type:Individual
Prefix:
First Name:SUSANA
Middle Name:
Last Name:CANTALAPIEDRA
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 1:300 AVE LA SIERRA
Mailing Address - Street 2:BOX 89
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4330
Mailing Address - Country:US
Mailing Address - Phone:787-758-2000
Mailing Address - Fax:787-977-5062
Practice Address - Street 1:AVE PONCE DE LEON
Practice Address - Street 2:BOX 191227, AUXILIO MUTUO HOSPITAL
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-1000
Practice Address - Country:US
Practice Address - Phone:787-758-2000
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12619207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine