Provider Demographics
NPI:1881759181
Name:LLORENS PEREZ, SANTIAGO (MD)
Entity type:Individual
Prefix:
First Name:SANTIAGO
Middle Name:
Last Name:LLORENS PEREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 TURQUESA STREET URB VISTA VERDE
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682-2514
Mailing Address - Country:US
Mailing Address - Phone:787-834-4392
Mailing Address - Fax:787-833-3234
Practice Address - Street 1:50 TENERIFE RESIDENCIAL SULTANA
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-1462
Practice Address - Country:US
Practice Address - Phone:787-265-1000
Practice Address - Fax:787-833-3234
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4631208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics