Healthcare Provider Details

I. General information

NPI: 1811479231
Provider Name (Legal Business Name): JONATHAN A SANTOS GARCIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2018
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 CARR 535 HACIENDAS DE CASA BLANCA
JUANA DIAZ PR
00795
US

IV. Provider business mailing address

514 CARR 535 HACIENDAS DE CASA BLANCA
JUANA DIAZ PR
00795
US

V. Phone/Fax

Practice location:
  • Phone: 787-241-7781
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number21096
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: