Provider Demographics
NPI:1639971971
Name:SANTOS, IRVING
Entity type:Individual
Prefix:MR
First Name:IRVING
Middle Name:
Last Name:SANTOS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SANTA JUANA II
Mailing Address - Street 2:15 ST, #N26
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-286-5195
Mailing Address - Fax:787-286-5190
Practice Address - Street 1:SANTA JUANA II
Practice Address - Street 2:15 ST, #N26
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-286-5195
Practice Address - Fax:787-286-5190
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier