Individual provider Active NPI

Rolando Q Santos, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Hollywood, FL
National Provider Identifier
1124094701
Registry record updated Aug 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
ARNP1525862 Issued in FL
Practice address
3400 N 29TH Ave
Hollywood, FL 33020
Phone
(954) 276-3400
Fax
(954) 965-6444
NPI assigned
Feb 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X ARNP1525862 FL Primary

Addresses

Primary practice location

3400 N 29TH Ave
Hollywood, FL 33020

Mailing address

2900 Corporate Way
Door D
Miramar, FL 33025-3925
Phone (954) 276-5685

Other identifiers 1

IdentifierTypeStateIssuer
304267700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533772800000",
    "number": "1124094701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "telephone_number": "954-276-5685",
            "fax_number": "954-985-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 N 29TH AVE",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "33020",
            "telephone_number": "954-276-3400",
            "fax_number": "954-965-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "ROLANDO",
        "middle_name": "Q",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2018-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARNP1525862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "304267700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.