Santelices, Samuel

Santelices, Samuel is an individual health care provider with primary practice located at 1859 Sw Newland Way , Lake City FL 32025-6966. He recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as his primary health care specialty. Santelices, Samuel can be contacted via phone (386) 758-0003.

Contact Information

Primary practice address
1859 Sw Newland Way Lake City FL 32025-6966
Phone: (386) 758-0003
Fax: (386) 755-7940
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X ME87551 Florida

Profile Details

NPI number 1669476552
LBN Legal business name Santelices, Samuel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2005
Last updated Jan 24th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669476552 NPPES
Florida MEDICAID 267374600

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