Provider Demographics
NPI:1386458917
Name:SANTOS BARROS, EVA ELENA
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:ELENA
Last Name:SANTOS BARROS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 45TH ST W
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33971-3970
Mailing Address - Country:US
Mailing Address - Phone:239-457-2590
Mailing Address - Fax:
Practice Address - Street 1:3201 45TH ST W
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33971-3970
Practice Address - Country:US
Practice Address - Phone:239-457-2590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBACB1190704106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician