Basic Information
| Provider Information | |||||||||
| NPI: | 1528171261 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SANTOS - SANTOS | ||||||||
| FirstName: | FIDEL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 98 CALLE 1 | ||||||||
| Address2: | PASEO LAS VISTAS | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009265943 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7873977188 | ||||||||
| FaxNumber: | 7877773855 | ||||||||
| Practice Location | |||||||||
| Address1: | TORRE PLAZA LAS AMERICAS SUITE 1210 | ||||||||
| Address2: | 525 AVE FD ROOSEVELT | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00918 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877513326 | ||||||||
| FaxNumber: | 7877587562 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2006 | ||||||||
| LastUpdateDate: | 05/08/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 6545 | PR | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207VF0040X | 6545 | PR | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Female Pelvic Medicine and Reconstructive Surgery |
No ID Information.