Provider Demographics
NPI:1275044786
Name:SANTOS, ROMULUS ANICETE (PT)
Entity Type:Individual
Prefix:MR
First Name:ROMULUS
Middle Name:ANICETE
Last Name:SANTOS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 777851
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89077-7851
Mailing Address - Country:US
Mailing Address - Phone:702-893-3333
Mailing Address - Fax:702-413-7775
Practice Address - Street 1:6462 LOSEE RD.
Practice Address - Street 2:STE. 135
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89086
Practice Address - Country:US
Practice Address - Phone:702-625-4809
Practice Address - Fax:702-462-5218
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-24
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25843225100000X
NV3937225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist