MEDICARE: DR. EDGARDO 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	207RH0003X	Hematology & Oncology Physician	15621R	LA
2	207RH0003X	Hematology & Oncology Physician	ME83677	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	:	1639260771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDGARDO SANTOS MD

Provider Business Mailing Address
First Line	:	500 SE 17TH ST STE 100
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33316-2547
Country	:	US
Telephone Number	:	754-336-3426
Fax Number	:	754-241-4659

Provider Business Practice Location Address
First Line	:	500 SE 17TH ST STE 100
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33316-2547
Country	:	US
Telephone Number	:	754-336-3426
Fax Number	:	754-241-4659

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

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	07/17/2024

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Directions to “ DR. EDGARDO SANTOS MD” Practice Location

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