Doctor Name: | JOHN ANTONIO SANTOS |
NPI Number: | 1114160272 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | FNP-BC |
License Number: | ARNP9249583 |
Business Practice Address: | 17820 Se 109th Ave Ste 108 Summerfield, FL - 344918968 |
Business Phone Number: | 3212976940 |
Business Fax Number: | |
Mailing Address: | 17820 Se 109th Ave Ste 108, SUMMERFIELD |
State: | FL |
Postal Code: | 344918968 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 04/19/2009 |
NPI Last Update Date: | 04/19/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | ARNP9249583 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |