Provider Demographics
NPI:1992002141
Name:SANTOS, DANETTE (LND; MPH)
Entity type:Individual
Prefix:MS
First Name:DANETTE
Middle Name:
Last Name:SANTOS
Suffix:
Gender:F
Credentials:LND; MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 CALLE JUAN B RODRIGUEZ APT 10012
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-2523
Mailing Address - Country:US
Mailing Address - Phone:787-414-7417
Mailing Address - Fax:
Practice Address - Street 1:650 CALLE LLOVERA EDIF. CENTRO PLAZA SUITE 103
Practice Address - Street 2:SANTURCE
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909
Practice Address - Country:US
Practice Address - Phone:787-723-4555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-24
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1206133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education