Healthcare Provider Details

I. General information

NPI: 1144625633
Provider Name (Legal Business Name): ADELAIDA SANTOS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2014
Last Update Date: 01/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1541 BRICKELL AVE APT 2001
MIAMI FL
33129-1222
US

IV. Provider business mailing address

1541 BRICKELL AVE APT 2001
MIAMI FL
33129-1222
US

V. Phone/Fax

Practice location:
  • Phone: 786-281-9857
  • Fax: 786-332-3976
Mailing address:
  • Phone: 786-281-9857
  • Fax: 786-332-3976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9306679
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: