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General NPI Number Information
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NPI Number | 1902091036
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Entity Type | Individual
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Provider Name | MARTIN JOHN DESANTIS D.O.
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Gender | Male
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Dates
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Enumeration Date | 09/12/2007
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 2621 CATTLEMEN RD STE 204
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City | SARASOTA
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State | FL
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Zip | 34232-6212
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Country | US
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Telephone | 941-326-3223
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Fax | 941-348-1304
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Provider Business Mailing Address
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Address Line | 2606 CENTENNIAL PL
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City | TALLAHASSEE
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State | FL
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Zip | 32308-0572
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Country | US
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Telephone | 850-205-0189
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Fax | 941-348-1304
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | OS15394
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License Number State | FL
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