Provider Demographics
NPI:1669542486
Name:RIOSSANTONI, LUCAS JORGE (MD)
Entity type:Individual
Prefix:DR
First Name:LUCAS
Middle Name:JORGE
Last Name:RIOSSANTONI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 1303
Mailing Address - Street 2:
Mailing Address - City:GUANICA
Mailing Address - State:PR
Mailing Address - Zip Code:00653-1303
Mailing Address - Country:US
Mailing Address - Phone:787-821-2320
Mailing Address - Fax:787-821-7362
Practice Address - Street 1:12 CALLE YAGUER
Practice Address - Street 2:
Practice Address - City:GUANICA
Practice Address - State:PR
Practice Address - Zip Code:00653-2533
Practice Address - Country:US
Practice Address - Phone:787-821-2320
Practice Address - Fax:787-821-7362
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR5130170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2381OtherPREFERRED MEDICARE CHOICE
PR100354WOtherMEDICARE Y MUCHO MAS
1130OtherFIRST MEDICAL HEALTH PLAN
PR582626003OtherLA CRUZ AZUL
PR01802OtherAMERICAN HEALTH INC.
PR66011111101OtherMCS MEDICAL CARD SYSTEM
PR6530012OtherHUMANA HEALTH PLAN
PR26400OtherREFORMA DE SSS
PR201762OtherPREFERRED HEALTH
1130OtherFIRST MEDICAL HEALTH PLAN
PR2381OtherPREFERRED MEDICARE CHOICE