NPI: 1477932671 · TOA BAJA, PR 00949 · Surgical Oncology Physician · NPI assigned 05/21/2015
| Authorized Official | SANTIAGO, CARLOS (PRESIDENT) |
| NPI Enumeration Date | 05/21/2015 |
Other providers sharing the same authorized official: SANTIAGO, CARLOS
| Provider | City | State | Total Paid |
|---|---|---|---|
| FUPS DENTAL, INC. | JACKSONVILLE | FL | $49K |
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 12 | $420.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99254 | 12 | 12 | $420.00 |