Individual
GENEROSA SANTOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1430 PALMETTO ST, CLEARWATER, FL 33755-5056
(727) 443-6010
(727) 443-6010
Mailing address
1430 PALMETTO ST, CLEARWATER, FL 33755-5056
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
AL8472
FL
310400000X
Assisted Living Facility
Primary
AL8472
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013592400
—
FL
05
—
687635896
—
FL
Enumeration date
09/18/2013
Last updated
03/23/2016
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