Provider Demographics
NPI:1619974250
Name:PEREZ SANTINI, IBSEN (MD)
Entity type:Individual
Prefix:DR
First Name:IBSEN
Middle Name:
Last Name:PEREZ SANTINI
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 1:100 CALLE DEL MUELLE
Mailing Address - Street 2:CAPITOLIO PLAZA SUITE 501
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00901-2616
Mailing Address - Country:US
Mailing Address - Phone:787-289-2222
Mailing Address - Fax:787-289-2222
Practice Address - Street 1:100 CALLE DEL MUELLE
Practice Address - Street 2:CAPITOLIO PLAZA SUITE 501
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00901-2616
Practice Address - Country:US
Practice Address - Phone:787-289-2222
Practice Address - Fax:787-289-2222
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-28
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13848207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ111330Medicare PIN
AZI06297Medicare UPIN