Provider Demographics
NPI:1730972597
Name:SANTOS, OLIVER (APRN)
Entity type:Individual
Prefix:
First Name:OLIVER
Middle Name:
Last Name:SANTOS
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:OLIVER
Other - Middle Name:S
Other - Last Name:SANTOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PMHNP
Mailing Address - Street 1:11251 SW 240TH LN
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-3108
Mailing Address - Country:US
Mailing Address - Phone:786-350-9937
Mailing Address - Fax:
Practice Address - Street 1:11251 SW 240TH LN
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-3108
Practice Address - Country:US
Practice Address - Phone:786-350-9937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN110396462084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry