Healthcare Provider Details

I. General information

NPI: 1497758221
Provider Name (Legal Business Name): MARIA B SANTOS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 05/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1503 BUENOS AIRES BLVD STE 180
THE VILLAGES FL
32159
US

IV. Provider business mailing address

1503 BUENOS AIRES BLVD STE 180
THE VILLAGES FL
32159-6822
US

V. Phone/Fax

Practice location:
  • Phone: 352-323-1482
  • Fax: 352-259-0748
Mailing address:
  • Phone: 352-323-1482
  • Fax: 352-259-0748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberME0081152
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: