Provider Demographics
NPI:1831997691
Name:SANTIS, RODRIGO BROLIN (PT)
Entity type:Individual
Prefix:
First Name:RODRIGO
Middle Name:BROLIN
Last Name:SANTIS
Suffix:
Gender:
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 INDUSTRIAL DR STE 210
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-2803
Mailing Address - Country:US
Mailing Address - Phone:302-635-9009
Mailing Address - Fax:302-449-2047
Practice Address - Street 1:4345 KIRKWOOD HWY STE 201
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-5131
Practice Address - Country:US
Practice Address - Phone:302-635-9009
Practice Address - Fax:302-449-2047
Is Sole Proprietor?:No
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0015027225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist