Provider Demographics
NPI:1497758221
Name:SANTOS, MARIA B (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:B
Last Name: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 1:1503 BUENOS AIRES BLVD STE 180
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32159-6822
Mailing Address - Country:US
Mailing Address - Phone:352-323-1482
Mailing Address - Fax:352-259-0748
Practice Address - Street 1:1503 BUENOS AIRES BLVD STE 180
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159
Practice Address - Country:US
Practice Address - Phone:352-323-1482
Practice Address - Fax:352-259-0748
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0081152208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL51617OtherBLUE CROSS BLUE SHEILD FL
FL51617YMedicare PIN
FLH48223Medicare UPIN