Provider Demographics
NPI:1265321855
Name:SANTOS, JOMAR CARRILLO (MAESTRIA)
Entity type:Individual
Prefix:MR
First Name:JOMAR
Middle Name:CARRILLO
Last Name:SANTOS
Suffix:
Gender:M
Credentials:MAESTRIA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CENTRO COMERCIAL HUMACAO
Mailing Address - Street 2:HUMACAO
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791
Mailing Address - Country:US
Mailing Address - Phone:787-295-3978
Mailing Address - Fax:
Practice Address - Street 1:CENTRO COMERCIAL HUMACAO
Practice Address - Street 2:HUMACAO
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791
Practice Address - Country:US
Practice Address - Phone:787-222-6043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7326103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist