Healthcare Provider Details

I. General information

NPI: 1477932671
Provider Name (Legal Business Name): CUIDANDO TUS SENOS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2015
Last Update Date: 05/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 AVE DOS PALMAS
TOA BAJA PR
00949-4101
US

IV. Provider business mailing address

PO BOX 633
DORADO PR
00646-0633
US

V. Phone/Fax

Practice location:
  • Phone: 787-784-5706
  • Fax: 787-795-0952
Mailing address:
  • Phone: 787-318-8930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number10298
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number10298
License Number StatePR

VIII. Authorized Official

Name: DR. CARLOS A SANTIAGO
Title or Position: PRESIDENT
Credential: MD., FACS
Phone: 787-205-9904