Provider Demographics
NPI:1972763951
Name:SANTAELLA DE FIGUEROA, GLORIA M (MD)
Entity type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:M
Last Name:SANTAELLA DE FIGUEROA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 190302
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-0302
Mailing Address - Country:US
Mailing Address - Phone:787-758-9517
Mailing Address - Fax:787-767-3175
Practice Address - Street 1:165 SUIZA STREET
Practice Address - Street 2:FLORAL PARK
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917
Practice Address - Country:US
Practice Address - Phone:787-758-9517
Practice Address - Fax:787-767-3175
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-12
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1899207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AS4223246OtherFEDERAL NARCOTIC
DM014639OtherPR NARCOTIC