Healthcare Provider Details

I. General information

NPI: 1962246223
Provider Name (Legal Business Name): ROBERT TORO SANTIAGO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2024
Last Update Date: 06/21/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

JOSE CANDELAS, #1, MANATI MEDICAL PLAZA SUITE 109
MANATI PR
00674
US

IV. Provider business mailing address

PO BOX 50910
TOA BAJA PR
00950-0910
US

V. Phone/Fax

Practice location:
  • Phone: 787-309-9417
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROBERT TORO SANTIAGO
Title or Position: SOLE MEMBER/PRESIDENT
Credential: MD
Phone: 787-309-9417