Provider Demographics
NPI:1245213016
Name:SANTOS, JOSEPH JR (MPAS, PA-C)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:SANTOS
Suffix:JR
Gender:M
Credentials:MPAS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:U.S. EMBASSY-QUITO
Mailing Address - Street 2:UNIT 5314
Mailing Address - City:APO
Mailing Address - State:AA
Mailing Address - Zip Code:34039
Mailing Address - Country:EC
Mailing Address - Phone:931-538-4109
Mailing Address - Fax:
Practice Address - Street 1:U.S. EMBASSY-QUITO
Practice Address - Street 2:UNIT 5314
Practice Address - City:APO
Practice Address - State:AA
Practice Address - Zip Code:34039
Practice Address - Country:EC
Practice Address - Phone:931-538-4109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN608363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical