MEDICARE: DR. CARLOS FERMIN VIERA SANTOS MD

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	174400000X	Specialist	ME 94213	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	:	1043256472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARLOS FERMIN VIERA SANTOS MD

Provider Business Mailing Address
First Line	:	1903 HOLLYHOCK RD
Second Line	:
City	:	WELLINGTON
State	:	FL
Zip	:	33414-8651
Country	:	US
Telephone Number	:	561-804-1237
Fax Number	:

Provider Business Practice Location Address
First Line	:	1840 FOREST HILL BLVD
Second Line	:	SUITE 101
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-6063
Country	:	US
Telephone Number	:	561-964-1181
Fax Number	:	561-964-1196

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

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	08/25/2007

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