MEDICARE: CUIDANDO TUS SENOS, LLC

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	2086X0206X	Surgical Oncology Physician	10298	PR
2	208600000X	Surgery Physician	10298	PR

General Provider Information

NPI Number	:	1477932671
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CUIDANDO TUS SENOS, LLC

Provider Business Mailing Address
First Line	:	PO BOX 633
Second Line	:
City	:	DORADO
State	:	PR
Zip	:	00646-0633
Country	:	US
Telephone Number	:	787-318-8930
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 AVE DOS PALMAS
Second Line	:
City	:	TOA BAJA
State	:	PR
Zip	:	00949-4101
Country	:	US
Telephone Number	:	787-784-5706
Fax Number	:	787-795-0952

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CARLOS A SANTIAGO
Credential	:	MD., FACS
Telephone Number	:	787-205-9904

Provider Enumeration Date	:	05/21/2015
Last Update Date	:	05/21/2015

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