Doctor Name: | MR. CARLOS SANTOS GONZALEZ |
NPI Number: | 1114990835 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 5077 |
Business Practice Address: | 730 J Andino Ave Villa Prades San Juan, PR - 009242205 |
Business Phone Number: | 7872508407 |
Business Fax Number: | 7872508407 |
Mailing Address: | 730 J Andino Ave, Villa Prades SAN JUAN |
State: | PR |
Postal Code: | 009242205 |
Phone Number: | 7872508407 |
Fax Number: | 7872508407 |
NPI Enumeration Date: | 02/13/2006 |
NPI Last Update Date: | 11/03/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 5077 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |