Individual
DR. LUZVIMINDA REPASO SANTOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3535 S JEFFERSON AVE STE 107, ALEXIUS BROTHERS, JEFFERSON DIVISION MEDICAL BLDG., SAINT LOUIS, MO 63118-3907
(314) 776-6575
(314) 776-6818
Mailing address
3535 S JEFFERSON AVE STE 107, ALEXIUS BROTHERS, JEFFERSON DIVISION MEDICAL BLDG., SAINT LOUIS, MO 63118-3907
(314) 776-6575
(314) 776-6818
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
RIC-50
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
#2001507
MO. CONTROLLED SUBSTANCE
MO
Enumeration date
12/26/2006
Last updated
03/07/2023
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