Healthcare Provider Details

I. General information

NPI: 1811834468
Provider Name (Legal Business Name): KEVIN EMILIAN SANTOS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB. MONTE SOL CALLE AMELIA MERCADO 401
JUANA DIAZ PR
00795
US

IV. Provider business mailing address

URB. MONTE SOL CALLE AMELIA MERCADO 401
JUANA DIAZ PR
00795
US

V. Phone/Fax

Practice location:
  • Phone: 787-990-6422
  • Fax:
Mailing address:
  • Phone: 787-990-6422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number17581I
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: