MEDICARE: BUITRAGO & SANTAELLA, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246ZE0500X	EEG Specialist/Technologist

General Provider Information

NPI Number	:	1134354467
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUITRAGO & SANTAELLA, INC.

Provider Business Mailing Address
First Line	:	PO BOX 7612
Second Line	:
City	:	PONCE
State	:	PR
Zip	:	00732-7612
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2909 AVE EMILIO FAGOT
Second Line	:
City	:	PONCE
State	:	PR
Zip	:	00716-3613
Country	:	US
Telephone Number	:	787-842-2600
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	ROSEMY BUITRAGO
Credential	:
Telephone Number	:	787-842-2600

Provider Enumeration Date	:	05/15/2009
Last Update Date	:	05/15/2009

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