Individual ProviderEdel SantosNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address8101 SW 72nd Ave Apt 220w, Miami, FL 33143-7617(786) 287-6537PECOS EnrollmentBased on the most recent information from CMS, provider Edel Santos is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1417983248Provider TypeIndividualFull NameSantos, EdelCredentialARNP, FNP-CGenderMaleSole ProprietorYesEnumeration Date6/23/2006Last Updated1/27/2018Contact InformationPractice LocationPractice Address8101 SW 72nd Ave Apt 220w, Miami, FL 33143-7617Phone(786) 287-6537FaxUnlisted FaxMailing LocationMailing Address8101 SW 72nd Ave Apt 220w, Miami, FL 33143-7617Phone(786) 287-6537FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseARNP9299615FloridaProvider IdentifiersIDDescriptionIssuerID764528700DescriptionMedicaidIssuerUnlistedFlorida