Provider Demographics
NPI:1316099237
Name:RODRIGUEZ SANTANA, ANIBAL (MD)
Entity type:Individual
Prefix:DR
First Name:ANIBAL
Middle Name:
Last Name:RODRIGUEZ SANTANA
Suffix:
Gender:M
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 1283
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-1283
Mailing Address - Country:US
Mailing Address - Phone:787-872-3730
Mailing Address - Fax:787-872-3733
Practice Address - Street 1:1401 AVE FELIX ALDARONDO
Practice Address - Street 2:
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-5941
Practice Address - Country:US
Practice Address - Phone:787-872-3730
Practice Address - Fax:787-872-3733
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14525146D00000X, 208D00000X, 261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service