Healthcare Provider Details

I. General information

NPI: 1194641209
Provider Name (Legal Business Name): CEZAR AGOSTO ARQUINIO-DOS SANTOS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8040 IANS ALY
LAUREL MD
20724-6133
US

IV. Provider business mailing address

3547 CARRIAGE WALK LN
LAUREL MD
20724-2052
US

V. Phone/Fax

Practice location:
  • Phone: 240-370-4943
  • Fax:
Mailing address:
  • Phone: 240-370-4943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: