Provider Demographics
NPI:1982843652
Name:GLORIMAR SANTOS LLANOS PSC
Entity Type:Organization
Organization Name:GLORIMAR SANTOS LLANOS PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLORIMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-460-5346
Mailing Address - Street 1:#339 CALLE FLOR DE NONO
Mailing Address - Street 2:URB. RIVER GARDENS
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729
Mailing Address - Country:US
Mailing Address - Phone:787-460-5346
Mailing Address - Fax:
Practice Address - Street 1:EAST MEDICAL & PROFFESSIONAL CENTER
Practice Address - Street 2:CARRETERA #3 KM 19.9
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729
Practice Address - Country:US
Practice Address - Phone:787-256-5555
Practice Address - Fax:787-256-5555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-19
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty