Healthcare Provider Details

I. General information

NPI: 1356865646
Provider Name (Legal Business Name): ALEXANDRA RAQUEL SANTANA ALMANSA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2017
Last Update Date: 08/05/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 CALLE BAEZ
SAN JUAN PR
00917-5020
US

IV. Provider business mailing address

15 MUNOZ RIVERA AVE SUITE 100 B PMB 120
SAN JUAN PR
00901
US

V. Phone/Fax

Practice location:
  • Phone: 787-767-6710
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number24067
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number24067
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: