Individual
YASMIN V FUENTES-SANTIAGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
15 CALLE CULTO, COROZAL, PR 00783-1918
(787) 802-1771
Mailing address
PO BOX 738, COROZAL, PR 00783-0738
(787) 802-1771
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9978
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100117
MMM
PR
01
—
3654-6
PROSSAM
PR
01
—
89542
BLUE SHIELD OF PR
PR
01
—
P367
FIRST MEDICAL
PR
Enumeration date
08/18/2006
Last updated
07/08/2007
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