Individual ProviderTeresa D SantosPediatricsAllopathic & Osteopathic PhysiciansPractice Address9611 W Broward Blvd, Plantation, FL 33324-2334(954) 424-7000(954) 614-5520PECOS EnrollmentBased on the most recent information from CMS, provider Teresa D Santos does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 15 days ago.Profile DetailsProvider ID1578552303Provider TypeIndividualFull NameSantos, Teresa DCredentialMDGenderFemaleSole ProprietorNoEnumeration Date10/14/2005Last Updated8/31/2020Contact InformationPractice LocationPractice Address9611 W Broward Blvd, Plantation, FL 33324-2334Phone(954) 424-7000Fax(954) 424-6003Mailing LocationMailing Address1636 S Ocean Dr, Ft Lauderdale, FL 33316-3244Phone(954) 614-5520FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode208000000XPrimaryDescriptionPediatricsAllopathic & Osteopathic PhysiciansLicenseME56353FloridaProvider IdentifiersIDDescriptionIssuerID373798500DescriptionMedicaidIssuerUnlistedFlorida