Provider Demographics
NPI:1750842043
Name:SANTOS, ANDREW MANZATTO (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:MANZATTO
Last Name:SANTOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4613 S ORANGE BLOSSOM TRL
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-1705
Mailing Address - Country:US
Mailing Address - Phone:407-232-9833
Mailing Address - Fax:407-232-9829
Practice Address - Street 1:4613 S ORANGE BLOSSOM TRL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32839-1705
Practice Address - Country:US
Practice Address - Phone:407-232-9833
Practice Address - Fax:407-232-9829
Is Sole Proprietor?:No
Enumeration Date:2019-03-28
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME157786207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine