Provider Demographics
NPI:1053903765
Name:DELOSSANTOS, ALBERTINO E
Entity type:Individual
Prefix:
First Name:ALBERTINO
Middle Name:E
Last Name:DELOSSANTOS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 HIATT DR
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-8222
Mailing Address - Country:US
Mailing Address - Phone:815-405-8181
Mailing Address - Fax:
Practice Address - Street 1:357 HIATT DR
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-8222
Practice Address - Country:US
Practice Address - Phone:815-405-8181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health