Provider Demographics
NPI:1962029801
Name:SANTOS, IRMARY (RN)
Entity Type:Individual
Prefix:
First Name:IRMARY
Middle Name:
Last Name:SANTOS
Suffix:
Gender:F
Credentials:RN
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 1307
Mailing Address - Street 2:
Mailing Address - City:CIDRA
Mailing Address - State:PR
Mailing Address - Zip Code:00739-1307
Mailing Address - Country:US
Mailing Address - Phone:787-224-3734
Mailing Address - Fax:
Practice Address - Street 1:LA FUENTE TOWN CENTER 706 CALLE MARGINAL
Practice Address - Street 2:AVE PEDRO ALBIZU CAMPOS SUITE 109
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784-0078
Practice Address - Country:US
Practice Address - Phone:787-296-9777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-26
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR29474163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice