Provider Demographics
NPI:1871577361
Name:SANTA ANA ARCARAZ, ALFREDO SANTIAGO (MD)
Entity type:Individual
Prefix:DR
First Name:ALFREDO
Middle Name:SANTIAGO
Last Name:SANTA ANA ARCARAZ
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:P22 CALLE EL TORITO
Mailing Address - Street 2:COLINAS METROPOLITANAS
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5230
Mailing Address - Country:US
Mailing Address - Phone:787-790-8180
Mailing Address - Fax:
Practice Address - Street 1:300 CALLE CLEMSON
Practice Address - Street 2:UNIVERSITY GARDENS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927
Practice Address - Country:US
Practice Address - Phone:787-754-6868
Practice Address - Fax:787-753-1550
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-30
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9124174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR81305Medicare ID - Type Unspecified