Healthcare Provider Details

I. General information

NPI: 1124790431
Provider Name (Legal Business Name): MARIO ANDRES MARCE SANTURIO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2021
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

PO BOX 11731
SAN JUAN PR
00922-1731
US

V. Phone/Fax

Practice location:
  • Phone: 787-299-2024
  • Fax:
Mailing address:
  • Phone: 787-299-2024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35.156928
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: