Individual
DOMINGO A SANTOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6164 GRAND CYPRESS CIR, LAKE WORTH, FL 33463-7355
(561) 385-9102
Mailing address
6164 GRAND CYPRESS CIR, LAKE WORTH, FL 33463-7355
(561) 385-9102
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
S532-161-63-460-0
FL
Other
Enumeration date
10/23/2013
Last updated
10/23/2013
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