Provider Demographics
NPI:1407147820
Name:SANTOS, KAREL (LMT)
Entity Type:Individual
Prefix:
First Name:KAREL
Middle Name:
Last Name:SANTOS
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10933 W OKEECHOBEE RD UNIT 102
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-8117
Mailing Address - Country:US
Mailing Address - Phone:786-218-7778
Mailing Address - Fax:
Practice Address - Street 1:10933 W OKEECHOBEE RD UNIT 102
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-8117
Practice Address - Country:US
Practice Address - Phone:786-218-7778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA61128175F00000X
FLPTA26274175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMA61128OtherLMT