Provider Demographics
NPI:1316354749
Name:SANTANA, CLORIAM (MD)
Entity type:Individual
Prefix:DR
First Name:CLORIAM
Middle Name:
Last Name: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:AX11 CALLE HERMOSILLO
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4696
Mailing Address - Country:US
Mailing Address - Phone:787-669-1254
Mailing Address - Fax:787-755-9478
Practice Address - Street 1:#18 CALLE DR. RAMON EMETERIO BETANCES,
Practice Address - Street 2:NORTE MAYAGUEZ, HOSP. SAN ANTONIO,
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-834-0050
Practice Address - Fax:787-834-2104
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-17
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18,830.208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice