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Individual

LUIS XAVIER RIVERA SANTANA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
610 E BELLA VISTA ST, LAKELAND, FL 33805-3008
(863) 688-8591
Mailing address
408 ASHFORD DR, BRANDON, FL 33511-7204
(787) 217-1386

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary

Other

Enumeration date
06/10/2022
Last updated
06/10/2022
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