1922337211 NPI number — ROOSEVELT ANTONIO DE LOS SANTOS FLORIAN MD

NPI Number: 1922337211
Health Care Provider/Practitioner: ROOSEVELT ANTONIO DE LOS SANTOS FLORIAN MD

NPI Number : 1922337211 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1922337211",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DE LOS SANTOS FLORIAN",
    "FirstName": "ROOSEVELT",
    "MiddleName": "ANTONIO",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "900 S PINE ISLAND RD STE 800",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PLANTATION",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33324-3923",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1695 N PARK DR STE 101",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WESTON",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33326-3294",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "954-389-7000",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/15/2009",
    "LastUpdateDate": "07/18/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "208000000X",
          "TaxonomyName": "Pediatrics Physician",
          "LicenseNumber": "ME106015",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "2083C0008X",
          "TaxonomyName": "Clinical Informatics Physician",
          "LicenseNumber": "ME106015",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}