Healthcare Provider Details

I. General information

NPI: 1669538385
Provider Name (Legal Business Name): ALVARO A SANTAELLA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE FONT MARTELO 317 NURSERY
HUMACAO PR
00792-0000
US

IV. Provider business mailing address

138 AVE WINSTON CHURCHILL MSC 660 EL SENORIAL MAIL STATION
SAN JUAN PR
00926-6013
US

V. Phone/Fax

Practice location:
  • Phone: 787-653-3434
  • Fax: 787-272-3493
Mailing address:
  • Phone: 787-272-3493
  • Fax: 787-272-6023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number6627
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: