Healthcare Provider Details

I. General information

NPI: 1750399044
Provider Name (Legal Business Name): ALFRED JOSEPH SANTORO DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 05/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16244 MILITARY TRL SUITE 760
DELRAY BEACH FL
33484-6534
US

IV. Provider business mailing address

16244 MILITARY TRL SUITE 760
DELRAY BEACH FL
33484-6534
US

V. Phone/Fax

Practice location:
  • Phone: 561-495-4950
  • Fax: 561-495-7817
Mailing address:
  • Phone: 561-495-4950
  • Fax: 561-495-7817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberCH0003597
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH3597
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: