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General NPI Number Information
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NPI Number | 1578737185
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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 | 04/15/2008
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Last Update Date | 02/23/2010
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Provider Practice Location Address
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Address Line | 16855 NE 2ND AVE SUITE 302A
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City | N MIAMI BEACH
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State | FL
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Zip | 33162-1744
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Country | US
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Telephone | 954-437-0803
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Fax | 954-437-0680
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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 | 954-437-0803
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Fax | 954-437-0680
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Authorized Official
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Title or Position | OWNER
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Name | DR. CARLOS R SANTOS
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Credential | MD
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Telephone | 954-437-0803
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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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