MEDICARE: ALBERTO SANTOS SR. MD

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	208D00000X	General Practice Physician	7179	PR

General Provider Information

NPI Number	:	1225121122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALBERTO SANTOS SR. MD

Provider Business Mailing Address
First Line	:	PO BOX 800383
Second Line	:	CALLE DEL PARQUE BLOQUE 1 SUITE 1
City	:	PONCE
State	:	PR
Zip	:	00780-0383
Country	:	US
Telephone Number	:	787-848-1005
Fax Number	:	787-840-8269

Provider Business Practice Location Address
First Line	:	CALLE DEL PARQUE BLOQUE 1
Second Line	:	SUITE 1 COTO LAUREL
City	:	PONCE
State	:	PR
Zip	:	00780-0383
Country	:	US
Telephone Number	:	787-848-1005
Fax Number	:	787-840-8269

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	07/08/2007

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