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General NPI Number Information
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NPI Number | 1114587326
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Entity Type | Individual
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Provider Name | AXEL JAVIER SANTIAGO CARLO MD
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Gender | Male
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Dates
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Enumeration Date | 06/19/2019
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 2319 S GEORGE ST
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City | YORK
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State | PA
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Zip | 17403-5009
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Country | US
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Telephone | 717-812-4090
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Fax |
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Provider Business Mailing Address
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Address Line | 601 MEMORY LN
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City | YORK
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State | PA
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Zip | 17402-2231
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Country | US
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Telephone | 717-851-1405
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Fax | 717-851-6969
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD478791
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 022281
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License Number State | PR
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Taxonomy #3
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | MD478791
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License Number State | PA
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