Healthcare Provider Details

I. General information

NPI: 1881203446
Provider Name (Legal Business Name): CESAR RAUL SANTOS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2020
Last Update Date: 09/04/2020
Certification Date: 09/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 CORAL WAY STE 202
MIAMI FL
33145-3053
US

IV. Provider business mailing address

3400 CORAL WAY STE 202
MIAMI FL
33145-3053
US

V. Phone/Fax

Practice location:
  • Phone: 305-856-1999
  • Fax: 305-856-7600
Mailing address:
  • Phone: 305-856-1999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: