Healthcare Provider Details

I. General information

NPI: 1568272433
Provider Name (Legal Business Name): DYNNA KEURIA SANTANA JIMENEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2025
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 AMERICO MIRANDA AVE. BO MONACILLOS
SAN JUAN PR
00922-2129
US

IV. Provider business mailing address

472 CALLE FELIPE R GOYCO
SAN JUAN PR
00915-3610
US

V. Phone/Fax

Practice location:
  • Phone: 787-777-3483
  • Fax:
Mailing address:
  • Phone: 787-988-8653
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number24214
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: