Healthcare Provider Details

I. General information

NPI: 1104875848
Provider Name (Legal Business Name): HECTOR SANTOS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ESCORIAL BUILDING ONE 1400 AVENUE SUR SUITE160
CAROLINA PR
00987
US

IV. Provider business mailing address

ESCORIAL BUILDING ONE 1400 AVENUE SUR SUITE160
CAROLINA PR
00987
US

V. Phone/Fax

Practice location:
  • Phone: 787-257-1511
  • Fax: 787-257-1881
Mailing address:
  • Phone: 787-257-1511
  • Fax: 787-257-1881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number13593
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: