Individual
IDALYS ANGEL SANTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13330 USF LAUREL DR, TAMPA, FL 33612-6601
(813) 821-8033
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 821-8038
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9120197
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126800300
—
FL
01
—
DPPSV
BCBS
FL
Enumeration date
03/19/2025
Last updated
11/07/2025
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