Provider Demographics
NPI:1346447224
Name:DOS SANTOS, KATIUSKA (MD)
Entity Type:Individual
Prefix:
First Name:KATIUSKA
Middle Name:
Last Name:DOS SANTOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5115 US HIGHWAY 27 N STE 100
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-1323
Mailing Address - Country:US
Mailing Address - Phone:863-385-2222
Mailing Address - Fax:863-382-8765
Practice Address - Street 1:5115 US HIGHWAY 27 N STE 100
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-1323
Practice Address - Country:US
Practice Address - Phone:863-385-2222
Practice Address - Fax:863-382-8765
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL116543208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHN548ZMedicare PIN