Healthcare Provider Details

I. General information

NPI: 1528974870
Provider Name (Legal Business Name): CARMELO SANTANA JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 DELAWARE AVE SW APT 727
WASHINGTON DC
20024-3938
US

IV. Provider business mailing address

768 ATLANTIC ST SE
WASHINGTON DC
20032-3739
US

V. Phone/Fax

Practice location:
  • Phone: 202-717-3880
  • Fax:
Mailing address:
  • Phone: 202-221-1602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: