Provider Demographics
NPI:1043827538
Name:SANTOS, ESTEBAN (ARNP)
Entity Type:Individual
Prefix:
First Name:ESTEBAN
Middle Name:
Last Name:SANTOS
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:ESTEBAN
Other - Middle Name:
Other - Last Name:SANTOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:1853 RAIN LILY PL
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34771-8557
Mailing Address - Country:US
Mailing Address - Phone:407-256-8373
Mailing Address - Fax:
Practice Address - Street 1:1182 CYPRESS GLEN CIR
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-7560
Practice Address - Country:US
Practice Address - Phone:407-350-5917
Practice Address - Fax:407-350-5928
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11009008363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily