Healthcare Provider Details

I. General information

NPI: 1760724777
Provider Name (Legal Business Name): GABRIEL SANTOS-DELGADO O.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2013
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PLAZA FAJARDO CARR 3 KM 43.3 LOCAL 125
FAJARDO PR
00738
US

IV. Provider business mailing address

CARR 3 KM 43.3 PLAZA FAJARDO, LOCAL 125
FAJARDO PR
00738
US

V. Phone/Fax

Practice location:
  • Phone: 787-801-5896
  • Fax:
Mailing address:
  • Phone: 787-558-5501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number00726
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: