Individual
LUIZ SANTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8745 N WICKHAM RD, MELBOURNE, FL 32940-5997
(321) 434-3474
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 434-3474
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
ME170610
FL
208M00000X
Hospitalist Physician
Primary
ME170610
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125231700
—
FL
01
—
UC791
MEDICARE HF
FL
Enumeration date
05/08/2021
Last updated
04/17/2025
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