MEDICARE: DR. ALFREDO G. SANTOS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	ME 45695	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023097581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALFREDO G. SANTOS M.D.

Provider Business Mailing Address
First Line	:	3 S POMPANO PKWY
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33069-3001
Country	:	US
Telephone Number	:	954-974-8901
Fax Number	:	954-970-5382

Provider Business Practice Location Address
First Line	:	3 S POMPANO PKWY
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33069-3001
Country	:	US
Telephone Number	:	954-974-8901
Fax Number	:	954-970-5382

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2006
Last Update Date	:	03/06/2013

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