Healthcare Provider Details

I. General information

NPI: 1477543197
Provider Name (Legal Business Name): MARIA DE LOS ANGELES SANTANA LEBRON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2005
Last Update Date: 04/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CALLE ADUANA
PUNTA SANTIAGO PR
00741-2401
US

IV. Provider business mailing address

PO BOX 931 PUNTA SANTIAGO
PUNTA SANTIAGO PR
00741-0931
US

V. Phone/Fax

Practice location:
  • Phone: 787-852-8545
  • Fax: 787-852-8545
Mailing address:
  • Phone: 787-852-8545
  • Fax: 787-852-8545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MARIA DE LOS A SANTANA
Title or Position: DIRECTOR
Credential: MT
Phone: 787-852-8545