Individual
MR. ROBERT SAMUEL DESANTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL1309
FL
390200000X
Student in an Organized Health Care Education/Training Program
AL-1309
FL
Other
Enumeration date
01/29/2007
Last updated
05/06/2010
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