Basic Information
| Provider Information | |||||||||
| NPI: | 1316354749 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SANTANA | ||||||||
| FirstName: | CLORIAM | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | AX11 CALLE HERMOSILLO | ||||||||
| Address2: | |||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009264696 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7876691254 | ||||||||
| FaxNumber: | 7877559478 | ||||||||
| Practice Location | |||||||||
| Address1: | #18 CALLE DR. RAMON EMETERIO BETANCES, | ||||||||
| Address2: | NORTE MAYAGUEZ, HOSP. SAN ANTONIO, | ||||||||
| City: | MAYAGUEZ | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00680 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878340050 | ||||||||
| FaxNumber: | 7878342104 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2014 | ||||||||
| LastUpdateDate: | 07/17/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 18,830. | PR | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.