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Individual

DR. JESSE DE LOS SANTOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1324 LAKELAND HILLS BLVD, LAKELAND, FL 33805-4543
(863) 687-1100
Mailing address
415 E PINE ST APT 1521, ORLANDO, FL 32801-6627

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME112913
FL

Other

Enumeration date
04/22/2010
Last updated
12/12/2012
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