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General NPI Number Information
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NPI Number | 1568792737
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Entity Type | Organization
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Legal Business Name | CARLOS R SANTOS MD PA
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Dates
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Enumeration Date | 01/11/2010
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Last Update Date | 05/08/2014
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Provider Practice Location Address
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Address Line | 3164 S UNIVERSITY DR
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City | MIRAMAR
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State | FL
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Zip | 33025-3001
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Country | US
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Telephone | 954-849-0621
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Fax | 305-653-4055
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Provider Business Mailing Address
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Address Line | PO BOX 198704
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City | ATLANTA
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State | GA
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Zip | 30384-8704
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Country | US
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Telephone | 305-653-0425
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Fax | 305-653-4055
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Authorized Official
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Title or Position | PRESIDENT
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Name | CARLOS SANTOS
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Credential | MD
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Telephone | 305-653-0425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | ME81286
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License Number State | FL
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