Provider Demographics
NPI:1124099478
Name:DI SANTI, JOEL A (DPM)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:A
Last Name:DI SANTI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2699 SEVILLE BLVD UNIT 402
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-1144
Mailing Address - Country:US
Mailing Address - Phone:724-493-3250
Mailing Address - Fax:
Practice Address - Street 1:2699 SEVILLE BLVD UNIT 402
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-1144
Practice Address - Country:US
Practice Address - Phone:724-493-3250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2020-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2045213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2700159OtherUNITED HEALTH CARE
TX00J03PMedicare ID - Type UnspecifiedMEDICARE
TX00J03POtherBCBS
TXT96233Medicare UPIN
TX5116360001Medicare NSC