Basic Information
| Provider Information | |||||||||
| NPI: | 1285163543 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SANTOS | ||||||||
| FirstName: | SELIN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PSY.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2950 CLEVELAND CLINIC BLVD | ||||||||
| Address2: | |||||||||
| City: | WESTON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333313625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9546595840 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3300 PGA BLVD STE 310 | ||||||||
| Address2: | |||||||||
| City: | PALM BEACH GARDENS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334102810 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5619836645 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2017 | ||||||||
| LastUpdateDate: | 05/23/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TH0004X | PY10595 | FL | N | Behavioral Health & Social Service Providers | Psychologist | Health | 103TC0700X | PY10595 | FL | N | Behavioral Health & Social Service Providers | Psychologist | Clinical | 103TH0100X | PY10595 | FL | N | Behavioral Health & Social Service Providers | Psychologist | Health Service | 103T00000X | PY10595 | FL | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.