Healthcare Provider Details

I. General information

NPI: 1629820501
Provider Name (Legal Business Name): THOMAS SANTUCCI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2024
Last Update Date: 04/03/2024
Certification Date: 04/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2061 BOCA RATON BLVD STE 204
BOCA RATON FL
33431-6774
US

IV. Provider business mailing address

2061 BOCA RATON BLVD STE 204
BOCA RATON FL
33431-6774
US

V. Phone/Fax

Practice location:
  • Phone: 561-278-2005
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175L00000X
TaxonomyHomeopath
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: