Provider Demographics
NPI:1518323088
Name:MARTI- SANTOS, GABRIEL (DC)
Entity Type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:
Last Name:MARTI- SANTOS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2013 LIVE OAK BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34771-8410
Mailing Address - Country:US
Mailing Address - Phone:407-498-4898
Mailing Address - Fax:407-530-0179
Practice Address - Street 1:2013 LIVE OAK BLVD STE D
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34771-8410
Practice Address - Country:US
Practice Address - Phone:407-498-4898
Practice Address - Fax:407-530-0179
Is Sole Proprietor?:No
Enumeration Date:2016-01-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 11610111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor