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NPI Code Detail

MEDICARE: JOSEPH P. SANTINI PA-C

MEDICARE: JOSEPH P. SANTINI PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician AssistantPA10005012WA
2363A00000XPhysician AssistantPA1957FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1E6835WOTHERFLPTAN

General Provider Information

NPI Number : 1386695211
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH P. SANTINI PA-C
Provider Business Mailing Address
First Line : 15051 S. TAMIAMI TRAIL
Second Line : SUITE 203
City : FORT MYERS
State : FL
Zip : 33908
Country : US
Telephone Number : 239-437-8810
Fax Number : 239-313-2555
Provider Business Practice Location Address
First Line : 60 WESTMINSTER ST N
Second Line :
City : LEHIGH ACRES
State : FL
Zip : 33936-6518
Country : US
Telephone Number : 239-368-9300
Fax Number : 239-368-9308
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2006
Last Update Date : 06/26/2015

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