Organization
BERNADETTE SANTOS MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BERNADETTE SANTOS MD (OWNER)
(352) 753-0581
Entity
Organization
Contact information
Practice address
1503 BUENOS AIRES BLVD STE 180, THE VILLAGES, FL 32159
(352) 323-1482
(352) 259-0748
Mailing address
121A LAGRANDE BLVD STE A, LADY LAKE, FL 32159-1302
(352) 753-0581
(352) 753-2078
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
ME81152
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
143942097
TRICARE PROVIDER NUMBER
FL
05
—
143942097
—
FL
01
—
51617
BLUE CROSS BLUE SHIELD PROVIDER NUMBER
FL
01
—
P00601026
RAILROAD MEDICARE PROVIDER NUMBER
FL
Enumeration date
01/11/2013
Last updated
05/29/2018
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