Individual
JOSE RAFAEL LABAULT-SANTIAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
140 JFK DR, ATLANTIS, FL 33462-6608
(561) 968-6767
(561) 641-0814
Mailing address
5700 LAKE WORTH RD, STE 204, GREENACRES, FL 33463-4727
(561) 966-7707
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
P3375
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14W87
BCBS
FL
Enumeration date
09/15/2008
Last updated
02/27/2015
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