MEDICARE: DR. ERICK F SANTOS HERNANDEZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0802X	Addiction Psychiatry Physician	3486	PR

General Provider Information

NPI Number	:	1558399071
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERICK F SANTOS HERNANDEZ MD

Provider Business Mailing Address
First Line	:	270 CALLE HARVARD
Second Line	:	UNIVERSITY GARDENS
City	:	SAN JUAN
State	:	PR
Zip	:	00927-4111
Country	:	US
Telephone Number	:	787-765-4589
Fax Number	:	787-281-6147

Provider Business Practice Location Address
First Line	:	270 CALLE HARVARD
Second Line	:	UNIVERSITY GARDENS
City	:	SAN JUAN
State	:	PR
Zip	:	00927-4111
Country	:	US
Telephone Number	:	787-765-4589
Fax Number	:	787-281-6147

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	07/08/2007

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