Healthcare Provider Details

I. General information

NPI: 1609917137
Provider Name (Legal Business Name): MARIA I SANTE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 03/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DEPARTAMENTO DE PATOLOGIA RCM EDIF. PRINCIPAL RCM PISO 3, OFIC 393
RIO PIEDRAS PR
00935
US

IV. Provider business mailing address

138 AVE WINSTON CHURCHILL MSC 660 EL SENORIAL MAIL STATION
SAN JUAN PR
00926-6013
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-2525
  • Fax: 787-754-0710
Mailing address:
  • Phone: 787-758-2525
  • Fax: 787-754-0710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZM0300X
TaxonomyMedical Microbiology Physician
License Number6931
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number6931
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: