Basic Information
Provider Information
NPI: 1588982755
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SANTOS-CUBINA
FirstName: JAVIER
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 60447
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 282600447
CountryCode: US
TelephoneNumber: 7043841246
FaxNumber: 7043841249
Practice Location
Address1: 200 HAWTHORNE LN
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 282042515
CountryCode: US
TelephoneNumber: 7043841246
FaxNumber: 7043841249
Other Information
ProviderEnumerationDate: 05/12/2010
LastUpdateDate: 10/25/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/24/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X268849NYN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
2084P0800X2014-00294NCY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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