Individual
AXEL JAVIER SANTIAGO CARLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 LAKELAND HILLS BLVD, LAKELAND, FL 33805-3065
(863) 680-7000
(866) 264-8519
Mailing address
1600 LAKELAND HILLS BLVD, LAKELAND, FL 33805-3065
(863) 680-7000
(866) 264-8519
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD478791
PA
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
MD478791
PA
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
ME178769
FL
208D00000X
General Practice Physician
022281
PR
Other
Enumeration date
06/19/2019
Last updated
04/27/2026
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