Provider Demographics
NPI:1952585960
Name:SANTOS TOMASSINI, SAMUEL FRANCISCO (MD)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:FRANCISCO
Last Name:SANTOS TOMASSINI
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:AVE #200 LOS CHALETS
Mailing Address - Street 2:CHALETS DE CUPEY APT #54
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:AVE #200 LOS CHALETS
Practice Address - Street 2:CHALETS DE CUPEY APT #54
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:939-642-8771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-27
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16964208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice