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Organization
LPS MEDICAL GROUP LLC
Active
Organization
LPS MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRUZ ADELMIS SANTOS MD (PHYSICIAN)
(407) 476-4011
Entity
Organization
Contact information
Practice address
1310 N MAIN ST STE 105, KISSIMMEE, FL 34744-4244
(407) 483-7975
(888) 772-5242
Mailing address
1310 N MAIN ST STE 105, KISSIMMEE, FL 34744-4244
(407) 483-7975
(888) 772-5242
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME107498
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004173700
—
FL
05
—
007-666-400
—
FL
01
—
FP292Y
MEDICARE PTAN
FL
01
—
HI271A
MEDICARE GROUP PTAN
FL
Enumeration date
12/03/2012
Last updated
12/06/2013
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