Individual
MRS. DIANA IDALIA SANTOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
CALLE PROGRESO #8 ALTOS, AGUADILLA, PR 00603-5008
(787) 819-0194
(787) 819-0194
Mailing address
CALLE PROGRESO #14, PMB 55, AGUADILLA, PR 00603-5008
(787) 819-0194
(787) 819-0194
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
6274
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16274
MCS
PR
01
—
2901 1
PROSSAM
PR
01
—
316274
UIA
PR
01
—
67065
BLUE CROSS
PR
Enumeration date
08/26/2005
Last updated
01/18/2011
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