Provider Demographics
NPI:1417616665
Name:SANTA MARIA, CARLOS (HOME HEALTH AIDE)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:
Last Name:SANTA MARIA
Suffix:
Gender:M
Credentials:HOME HEALTH AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 24TH ST NW APT 207
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-2505
Mailing Address - Country:US
Mailing Address - Phone:202-530-4446
Mailing Address - Fax:
Practice Address - Street 1:725 24TH ST NW APT 207
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-2505
Practice Address - Country:US
Practice Address - Phone:202-530-4446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA200001649374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide