Provider Demographics
NPI:1104067792
Name:RIVERA SANTANA, ZANYA O (MD)
Entity type:Individual
Prefix:DR
First Name:ZANYA
Middle Name:O
Last Name:RIVERA SANTANA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 303
Mailing Address - Street 2:
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610-0303
Mailing Address - Country:US
Mailing Address - Phone:787-826-3747
Mailing Address - Fax:
Practice Address - Street 1:CARR 405 KM 1.2 INT
Practice Address - Street 2:BO. CARRERAS
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610-0303
Practice Address - Country:US
Practice Address - Phone:787-826-3747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-12
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17504208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice