Healthcare Provider Details
I. General information
NPI: 1043338122
Provider Name (Legal Business Name): OCCUPATIONAL & AESTHETIC MEDICINE SERVICES, CSP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/27/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
CARR 31 JUNCOS PLAZA LOCAL D-2
JUNCOS PR
00777
US
IV. Provider business mailing address
PO BOX 1221
JUNCOS PR
00777-1221
US
V. Phone/Fax
- Phone: 787-713-6505
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
EMMANUEL
SANTOS
Title or Position: PRESIDENT
Credential: MD
Phone: 787-713-6505