Provider Demographics
NPI:1952031635
Name:CERDA SANTOS, JEAN C (MD)
Entity type:Individual
Prefix:DR
First Name:JEAN
Middle Name:C
Last Name:CERDA SANTOS
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 1:295 CALLE DIMAS PAGAN
Mailing Address - Street 2:
Mailing Address - City:GUAYANILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00656-1217
Mailing Address - Country:US
Mailing Address - Phone:787-477-7755
Mailing Address - Fax:
Practice Address - Street 1:8 CALLE JAVILLA
Practice Address - Street 2:
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-4102
Practice Address - Country:US
Practice Address - Phone:787-892-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-15
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR24106208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice