Healthcare Provider Details

I. General information

NPI: 1871717389
Provider Name (Legal Business Name): YADITZA COLON SANTINI MD PEDIATRIC SPECIAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE SAN LUIS STREET #129 KM NO 0.1 DR CAYETANO COIL Y TOSTE HOSPITAL
ARECIBO PR
00613
US

IV. Provider business mailing address

ADELFA B 23 LOMAS VERDES B23 ADELFA STREET LOMAS VERDES
BAYAMON PR
00956-3130
US

V. Phone/Fax

Practice location:
  • Phone: 787-878-7272
  • Fax: 787-650-7300
Mailing address:
  • Phone: 787-785-3605
  • Fax: 787-880-6263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number9381
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: