Provider Demographics
NPI:1528476504
Name:DELMA I SANTOS
Entity type:Organization
Organization Name:DELMA I SANTOS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GROUP DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DELMA
Authorized Official - Middle Name:I
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:787-438-6588
Mailing Address - Street 1:E23 CALLE 10
Mailing Address - Street 2:SANTA RITA
Mailing Address - City:VEGA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00692-6723
Mailing Address - Country:US
Mailing Address - Phone:787-438-6588
Mailing Address - Fax:
Practice Address - Street 1:E23 CALLE 10
Practice Address - Street 2:SANTA RITA
Practice Address - City:VEGA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00692-6723
Practice Address - Country:US
Practice Address - Phone:787-438-6588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CETIS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR792235Z00000X
PR836225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty